Potential impact of human papilloma virus on survival of basaloid squamous carcinoma of the head and neck.
OBJECTIVE
Basaloid-squamous-carcinomas (BSCC) have been considered as aggressive variants of common squamous-cell-carcinomas (HNSCC). Recent studies demonstrated a different clinical course depending on the tumour site. The aim of the study is to analyze the histopathologic/clinical features of BSCC/HNSCC resolved by the HPV-status.


METHODS
We analysed the histopathologic/clinical features of BSCC (n=59) and HNSCC (n=981), subdivided due to the HPV status. Differences were analysed using Chi square, Fisher exact, and student's t-test. Survival rates were calculated by Kaplan-Meier and log-rank test. Prognostic variables were subsequently evaluated by Cox regression.


RESULTS
Our cohort was congruent with the literature regarding sex, age, metastases, and a predilection in the oropharynx. HNSCC/BSCC did not show a different disease-specific-survival. After UICC matching, univariate analysis revealed a better survival of UICC stage IVa BSCC compared to HNSCC (69% vs. 42%, p=0.022) that was associated with a better response to radio-chemotherapy (p = 0.009). These results referred to the high prevalence of HPV+ (86%) oropharyngeal BSCC. Subgroup analysis demonstrated a better survival of HPV+ oropharyngeal BSCC than HPV- BSCC (p=0.017).


CONCLUSIONS
The clinical outcome in BSCC depends on the tumour site and HPV-status. Prospective studies have to evaluate the beneficial application of postoperative radio-chemotherapy in HPV+ BSCC.
Department of Otorhinolaryngology, Technical University Munich, München, Germany.
Christian
C
Jacobi
Department of Otorhinolaryngology, Technical University Munich, München, Germany.
Isabelle
I
Ayx
Department of Otorhinolaryngology, Technical University Munich, München, Germany.
Kristin
K
Fritsche
Department of Otorhinolaryngology, Technical University Munich, München, Germany.
Guido
G
Piontek
Institute of Virology, Technische Universität and Helmholtz Zentrum München, München, Germany.
Dieter
D
Hoffmann
Institute of Pathology, Technical University Munich, München, Germany.
Gregor
G
Weirich
Department of Otorhinolaryngology, Technical University Munich, München, Germany.
Andreas
A
Knopf
D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D002294:Carcinoma, Squamous Cell / Q000145:classification / Q000175:diagnosis / Q000401:mortality / Q000628:therapy / Q000821:virology*; D016009:Chi-Square Distribution; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000032:analysis; D004279:DNA, Viral / Q000235:genetics*; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000145:classification / Q000175:diagnosis / Q000401:mortality / Q000628:therapy / Q000821:virology*; D061809:Human Papillomavirus DNA Tests; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000401:mortality / Q000821:virology*; D011237:Predictive Value of Tests; D015995:Prevalence; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D000077195:Squamous Cell Carcinoma of Head and Neck; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D019941:Cyclin-Dependent Kinase Inhibitor p16; D004279:DNA, Viral