The importance of adjuvant treatment and primary anatomical site in head and neck basaloid squamous cell carcinoma survival: an analysis of the National Cancer Database.

PURPOSE: Basaloid squamous cell carcinoma (BSCC) of the head and neck is an aggressive and highly malignant variant of squamous cell carcinoma that accounts for 2% of head and neck cancers. Previous studies have not analyzed the significance of adjuvant chemoradiation and anatomical site within BSCC subtype and its impact on survival. METHODS: A cohort of 1999 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: 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 presence of metastasis increased the risk 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. Patients with microscopic margins had better survival outcomes when compared to no surgery (HR = 0.38, 98% Cl 0.23-0.64) while there were 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, and microscopic margins were associated with greater survival.

Basaloid squamous cell carcinoma: a 31-year retrospective study and analysis of 214 cases reported in the literature.

PURPOSE: The aim of this study was to analyze the clinical features of BSCC in the oral cavity, diagnosed over 31 years of service in oral pathology, and make comparisons with the data reported in the literature. METHODS: Data regarding gender, age, clinical presentation, anatomical location, symptoms, evolution time, size of lesion, and use of alcohol and tobacco from cases of BSCC were collected. Additionally, we conducted a review of BSCC studies from searches in three electronic databases. RESULTS: Among 24,570 oral biopsies, 7 (0.03%) were BSCC and represented 0.8% of oral squamous cell carcinoma (n = 875). All cases occurred in males, and the prevalent affected age was the sixth decade (60%). Ulcers occurred in all cases, with the majority showing no symptoms (71.4%). The tongue (30.8%), alveolar ridge/gingiva (30.8%), and floor of the mouth (23.1%) were the anatomical locations affected. The literature review indicated a total of fifteen publications, reporting 214 cases of BSCC. Males (76.7%) in the seventh (53.3%) decade of life were most affected. According to the cases with adequate information, symptomatic (90.0%) ulcers (80.0%) in the floor of the mouth (42.1%), with a mean size of 2 cm and the mean evolution time of 1.5 to 18 months were the most seen. Association with tobacco and alcohol use, when noted, was 50.0%. CONCLUSION: The features presented in this study are more similar than different when compared with the literature data.

Carcinoma de células escamosas basaloide en paladar: Reporte de caso

l carcinoma de células escamosas basaloide (CCEB) es una variante poco común y agresiva del carcinoma de células escamosas (CCE), con predilección por el tracto aerodigestivo superior, siendo el paladar un sitio muy raro de desarrollo. Está constituido por un componentes basaloide y uno escamoso en proporciones variables, sin embargo, las características histopatológicas del CCEB se superponen con otras neoplasias. El diagnóstico con diversos marcadores inmunohistoquímicos como p63, Ki67, p16, y citoqueratinas AE1 / AE3 se han convertido en una necesidad para el especialista. El objetivo de este trabajo es presentar un caso de CCEB en paladar blando y evidenciar la importancia del apoyo en la Iinmunohistoquímica para un diagnóstico histopatológico precoz. Se presenta además una revisión de literatura en cuanto a esta patología.

asaloid Squamous Cell Carcinoma (BSCC) is a rare and aggressive variant of squamous cell carcinoma (SCC), with a predilection for the upper aerodigestive tract, the palate being a very rare site of development. It is constituted by a basaloid and a squamous components in variable proportions, however, the histopathological characteristics of the BSCC overlap with other neoplasias. Diagnosis with various immunohistochemical markers such as p63, Ki67, p16, and AE1 / AE3 cytokeratins have become a necessity for the specialist. The objective of this study is to present a case of BSCC in soft palate and to show the importance of the support in the immunohistochemistry for an early histopathological diagnosis. A review of the literature on this pathology is also presented.

Comparative analysis of basaloid and conventional squamous cell carcinomas of the esophagus: prognostic relevance of clinicopathological features and protein expression.

Basaloid squamous cell carcinoma (BSCC), a variant of squamous cell carcinoma (SCC), is a rare and aggressive epithelial malignancy which has been reported in only 0.1-11 % of primary esophageal carcinomas. In this study, a comparison of clinicopathological features and protein expression between esophageal BSCC (EBSCC) and conventional esophageal SCC (ESCC) cases from Brazil was performed in order to find factors that can be relevant to better characterize EBSCC. The expression of HER2, epidermal growth factor receptor (EGFR), Ki-67, and cyclins (A, B1, and D1) in 111 cases (95 ESCC and 16 EBSCC) was evaluated by immunohistochemistry using tissue microarray. When the clinicopathological data were compared, no significant difference was found between the two histological types. Although the difference is not significant (p = 0.055), the EGFR expression was more frequent in the conventional ESCC than in the EBSCC group. Our results indicate that the clinicopathological profiles of conventional ESCC and EBSCC are similar and provide no indicators for differences in prognosis between these two groups.

Expression of adhesion proteins (E-cadherin and ß-catenin) and cell proliferation (Ki-67) at the invasive tumor front in conventional oral squamous cell and basaloid squamous cell carcinomas.

OBJECTIVE: Investigate, on a comparative basis, the expression of the adhesion molecules E-cadherin (E-cad), ß-catenin (ß-cat) and the proliferation index (Ki-67) at the invasive tumor front (ITF) in squamous cell carcinoma (SCC) and basaloid squamous cell carcinoma (BSCC). MATERIAL AND METHODS: Thirty-five SCC and 16 BSCC cases were evaluated by immunohistochemistry. Clinicopathological and survival data were also evaluated and compared. RESULTS: There was a low expression of E-cad in the cytoplasmic membrane (p=0.50) as well as in the nucleus (p=0.31) for both SCC and BSCC. A high expression of E-cad was seen in the cytoplasm for the SCC group (80%) when compared to the BSCC group (25%) (p<0.01). The expression of ß-cat was low in the cytoplasmic membrane and high in the cytoplasm in both SCC and BSCC groups. Both types of carcinoma presented low expressions of ß-cat in the nucleus (p=0.03). The Ki-67 expression was low irrespective of tumor variant. The high expression of E-cad in the cytoplasm was associated with T3/T4 tumors (p=0.04) in the SCC group and there was no significant association of E-cad, ß-cat, Ki-67 with the other clinical variables. In terms of disease-free survival and overall survival, there were no significant differences between SCC and BSCC. CONCLUSION: The E-cad-ß-cat system was found to be dysregulated in both oral SCC and oral BSCC. The Ki-67 cell proliferation index was extremely low in the cases investigated and consequently had no prognostic value.