Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis.
Department of Otolaryngology/Head & Neck Surgery, Indiana University School of Medicine, Indianapolis.
JAMA Otolaryngol Head Neck Surg. 2013 Dec;139(12):1306-11. doi: 10.1001/jamaoto.2013.5308.
Head and neck basaloid squamous cell carcinoma (BSCC) has been considered a more aggressive variant of squamous cell carcinoma (SCC) with a poorer prognosis, although case-control studies have reached conflicting conclusions.
To examine the prognostic significance of head and neck BSCC on overall survival in a large population-based registry.
Retrospective data review of a population-based registry from the Surveillance, Epidemiology, and End Results database.
Individual case data for 34,196 patients treated between January 2004 and December 2009 with head and neck primary SCC (n = 33,554) and BSCC (n = 642) of the oral cavity, oropharyx, larynx, or hypopharynx. Patients with metastatic disease, incomplete staging information, and those who did not receive surgery or radiation were excluded.
Patients had been treated with surgery, radiation, or both.
Distribution of patient characteristics between patients of each histology. Hazard ratios, 3-year overall survival, subgroup, and multivariate analysis of patient and treatment characteristics were investigated.
Across each cohort, patients with BSCC more often had high-grade tumors and treatment with lymph node dissection. Multivariate analysis found that group stage, T stage, N stage, size, lymph node dissection, and age statistically significantly influenced overall survival. In multivariate analysis, the hazard ratio for death for patients with BSCC in the oral cavity and larynx and hypopharynx was not statistically significantly different from that for SCC. In the oropharynx, the hazard ratio for death for BSCC histology compared with SCC histology was 0.73 (P = .03).
Compared with SCC, BSCC is not an independent adverse prognostic factor for patients with head and neck cancer. The Surveillance, Epidemiology, and End Results analysis has limits, including lack of information regarding chemotherapy, but after controlling for disease and treatment variables, including neck dissection and radiotherapy, BSCC histology did not have an independent adverse prognostic effect on overall survival. The reported association between human papillomavirus and BSCC histology may explain the lower hazard ratio for death in patients with oropharynx BSCC.
头颈部基底样鳞状细胞癌（BSCC）被认为是鳞状细胞癌（SCC）更具侵袭性的变异型，预后较差，尽管病例对照研究得出了相互矛盾的结论。
在大型基于人群的注册中心检查头颈部 BSCC 对总生存率的预后意义。
对来自监测、流行病学和最终结果数据库的基于人群的注册中心的回顾性数据分析。
2004 年 1 月至 2009 年 12 月期间接受治疗的头颈部原发性 SCC（n=33554）和口腔、口咽、喉或下咽 BSCC（n=642）的个体病例数据。排除患有转移性疾病、分期信息不完整以及未接受手术或放疗的患者。
患者接受了手术、放疗或两者的联合治疗。
在每个组织学组的患者中患者特征的分布。还调查了危险比、3 年总生存率、亚组和多变量分析患者和治疗特征。
在每个队列中，BSCC 患者更常患有高级别肿瘤和淋巴结清扫术。多变量分析发现，组阶段、T 阶段、N 阶段、大小、淋巴结清扫术和年龄对总生存率有统计学显著影响。在多变量分析中，BSCC 在口腔和喉及下咽与 SCC 相比，BSCC 患者的死亡风险比无统计学显著差异。在口咽，BSCC 组织学与 SCC 组织学相比，死亡风险比为 0.73（P=0.03）。
与 SCC 相比，BSCC 不是头颈部癌症患者的独立不良预后因素。监测、流行病学和最终结果分析存在局限性，包括缺乏关于化疗的信息，但在控制疾病和治疗变量（包括颈部清扫术和放疗）后，BSCC 组织学对总生存率没有独立的不良预后影响。报告的人类乳头瘤病毒与 BSCC 组织学之间的关联可能解释了口咽 BSCC 患者死亡风险比降低的原因。
