Meera Patel

BACKGROUND: Basaloid squamous cell carcinoma (BSCC) of the head and neck is an aggressive and highly malignant variant of squamous cell carcinoma that account for 2% of head and neck cancers. Previous studies have not analyzed the significance of adjuvant chemoradiation and anatomical site within basaloid squamous cell carcinoma subtype and its impact on survival.

METHODS: A cohort of 1,999 patients with BSCC of the head and neck was formed from the National Cancer Database and analyzed with descriptive studies, median survival and 5- and 10-year survival. A multivariable Cox hazard regression was performed to determine the prognostic significance of anatomical site and adjuvant therapy.

RESULTS: In this cohort, 82% were male with a median age of 59 years. The most common primary anatomical site was the oropharynx (71.9%) followed by oral cavity (11.5%), larynx (10.1%), hypopharynx (3.5%), esophagus (1.9%), and nasopharynx (1.1%). The majority of the cohort had stage IV disease, while 3.9% had metastases. The presence of metastasis increased probability of mortality (HR=2.14; 95% CI: 1.40-3.26). Tumors localized to the oropharynx demonstrated better survival compared to all sites except nasopharynx, including the oral cavity (HR=2.45; 95% CI: 1.83-3.29), hypopharynx (HR=2.58; 95% CI: 1.64-4.05), and larynx (HR=2.89; 95% CI: 2.25-3.73). Adjuvant chemoradiation (HR=0.36; 95% CI: 0.23-0.58) and adjuvant radiation (HR=0.38; 95% CI: 0.23-0.64) had better survival outcomes compared to adjuvant chemotherapy alone. Patients with microscopic tumor margins had better survival outcomes when compared to no surgery (HR=0.38, 98% Cl: 0.23-0.64) while there was no better survival outcomes of patients with macroscopic margins compared to no surgery.

CONCLUSION: This study illustrated that tumors in the oropharynx, lower age, adjuvant chemoradiation and radiation, microscopic margins or residual tumor were associated with greater survival. This study demonstrates the importance of these factors as independent prognostic factors when considering survival of patients diagnosed with BSCC of the head and neck.

BACKGROUND: Basaloid squamous cell carcinoma (BSCC) of the head and neck is an aggressive and highly malignant variant of squamous cell carcinoma that account for 2% of head and neck cancers. Previous studies have not analyzed the significance of adjuvant chemoradiation and anatomical site within basaloid squamous cell carcinoma subtype and its impact on survival.

METHODS: A cohort of 1,999 patients with BSCC of the head and neck was formed from the National Cancer Database and analyzed with descriptive studies, median survival and 5- and 10-year survival. A multivariable Cox hazard regression was performed to determine the prognostic significance of anatomical site and adjuvant therapy.

RESULTS: In this cohort, 82% were male with a median age of 59 years. The most common primary anatomical site was the oropharynx (71.9%) followed by oral cavity (11.5%), larynx (10.1%), hypopharynx (3.5%), esophagus (1.9%), and nasopharynx (1.1%). The majority of the cohort had stage IV disease, while 3.9% had metastases. The presence of metastasis increased probability of mortality (HR=2.14; 95% CI: 1.40-3.26). Tumors localized to the oropharynx demonstrated better survival compared to all sites except nasopharynx, including the oral cavity (HR=2.45; 95% CI: 1.83-3.29), hypopharynx (HR=2.58; 95% CI: 1.64-4.05), and larynx (HR=2.89; 95% CI: 2.25-3.73). Adjuvant chemoradiation (HR=0.36; 95% CI: 0.23-0.58) and adjuvant radiation (HR=0.38; 95% CI: 0.23-0.64) had better survival outcomes compared to adjuvant chemotherapy alone. Patients with microscopic tumor margins had better survival outcomes when compared to no surgery (HR=0.38, 98% Cl: 0.23-0.64) while there was no better survival outcomes of patients with macroscopic margins compared to no surgery.

CONCLUSION: This study illustrated that tumors in the oropharynx, lower age, adjuvant chemoradiation and radiation, microscopic margins or residual tumor were associated with greater survival. This study demonstrates the importance of these factors as independent prognostic factors when considering survival of patients diagnosed with BSCC of the head and neck.

BACKGROUND: Basaloid squamous cell carcinoma (BSCC) of the head and neck is an aggressive and highly malignant variant of squamous cell carcinoma that account for 2% of head and neck cancers. Previous studies have not analyzed the significance of adjuvant chemoradiation and anatomical site within basaloid squamous cell carcinoma subtype and its impact on survival.

METHODS: A cohort of 1,999 patients with BSCC of the head and neck was formed from the National Cancer Database and analyzed with descriptive studies, median survival and 5- and 10-year survival. A multivariable Cox hazard regression was performed to determine the prognostic significance of anatomical site and adjuvant therapy.

RESULTS: In this cohort, 82% were male with a median age of 59 years. The most common primary anatomical site was the oropharynx (71.9%) followed by oral cavity (11.5%), larynx (10.1%), hypopharynx (3.5%), esophagus (1.9%), and nasopharynx (1.1%). The majority of the cohort had stage IV disease, while 3.9% had metastases. The presence of metastasis increased probability of mortality (HR=2.14; 95% CI: 1.40-3.26). Tumors localized to the oropharynx demonstrated better survival compared to all sites except nasopharynx, including the oral cavity (HR=2.45; 95% CI: 1.83-3.29), hypopharynx (HR=2.58; 95% CI: 1.64-4.05), and larynx (HR=2.89; 95% CI: 2.25-3.73). Adjuvant chemoradiation (HR=0.36; 95% CI: 0.23-0.58) and adjuvant radiation (HR=0.38; 95% CI: 0.23-0.64) had better survival outcomes compared to adjuvant chemotherapy alone. Patients with microscopic tumor margins had better survival outcomes when compared to no surgery (HR=0.38, 98% Cl: 0.23-0.64) while there was no better survival outcomes of patients with macroscopic margins compared to no surgery.

CONCLUSION: This study illustrated that tumors in the oropharynx, lower age, adjuvant chemoradiation and radiation, microscopic margins or residual tumor were associated with greater survival. This study demonstrates the importance of these factors as independent prognostic factors when considering survival of patients diagnosed with BSCC of the head and neck.