Outcomes after radiotherapy for basaloid squamous cell carcinoma of the head and neck

Abstract

BACKGROUND.Basaloid squamous cell carcinoma (BSCC) is an uncommon, high‐grade variant of squamous cell carcinoma (SCC) of the head and neck. Its poorer prognosis compared with common SCC remains controversial. The authors investigated the outcomes of patients with BSCC who received radiotherapy and compared them with the outcomes of patients with SCC.METHODS.From 1994 to 2004, 1007 patients received radiotherapy for head and neck carcinoma with lymph node involvement. The histologic types consisted of 51 BSCC, 431 poorly differentiated SCC (PSCC), and 525 well or moderately differentiated SCC (WMSCC). A case–control analysis was performed with BSCC matched against both PSCC and WMSCC to compare disease‐control and survival rates.RESULTS.Patients with BSCC received treatment modalities similar to those received by patients with SCC: They received induction chemotherapy (12%) or concurrent chemotherapy (33%), and a median radiation dose of 70 Gray. Posttreatment viable tumor was present in 44%, 13%, and 28% of neck dissection specimens from patients with BSCC, PSCC, and WMSCC, respectively. The 5‐year disease‐free survival rates (63%, 77%, and 76%, respectively) and overall survival rates (85%, 70%, and 71%, respectively) demonstrated no statistically significant differences for BSCC, PSCC, or WMSCC, respectively.CONCLUSIONS.In this study, a poorer prognosis could not be demonstrated for irradiated patients with BSCC compared with either PSCC or WMSCC. All patients in this study had positive lymph node status, and the majority of patients (84%) had oropharyngeal cancer. The BSCC cohort did have a relatively high rate of viable tumor in their posttreatment neck dissections, and they had a relatively high rate of distant disease. On the basis of the high rate of lung metastases and the possibility of efficient salvage, the authors recommend obtaining a chest computed tomography scan during initial staging and follow‐up. Cancer 2008. © 2008 American Cancer Society.

Basaloid Squamous Cell Carcinoma of the Tonsil: A Rare Case

“…While some authors advocate more aggressive treatment with surgical excision and cervical dissection supplemented with adjuvant chemoradiotherapy in all cases [1,5,6,8], others advice a management similar to conventional SCC [10].…”

“…Basaloid squamous cell carcinoma (BSSC) is a distinct and rare variant of conventional squamous cell carcinoma (SCC), predominantly localized in the upper aerodigestive tract [1][2][3][4][5][6][7][8][9][10]. First described by Wain et al in 1986, it has a strong predilection for sites such as base of the tongue, hypo pharynx and supraglotic larynx [5,[8][9][10].…”

Basaloid Squamous Cell Carcinoma

“…Multifocal disease includes other sites in the head and neck, which were also documented [17] However, some controversy is still present regarding the prognosis and conflicting results, which have appeared in recent literature. Some published papers claimed they have similar prognosis to traditional squamous cell carcinoma [21]. The majority of these cases are found at an advanced stage, which could explain the poor clinical outcome and prognosis.…”

Angiogenesis in cutaneous disease: Part II

“…A patient with oropharyngeal carcinoma that had a cutaneous SCC metastasis with overexpression of EGFR still had a fatal outcome 3 months after the initial diagnosis of cancer, in spite of chemotherapy and treatment with cetuximab. 10 Ramadan et al 11 reported the complete clinical clearance of cutaneous SCC in a patient with multiple myeloma. The patient developed a moderately differentiated SCC on the left temple.…”