title: Basosquamous carcinoma of the head and neck: clinical and histologic characteristics and their impact on disease progression.
abstract: OBJECTIVE
  Basosquamous carcinoma (BSC) is a rare tumor entity, and the most common onset is in the head and neck region (BSC-HN). The data on diagnosis, treatment, and especially risk assessment concerning disease course and outcome are deficient or inconsistent. This study aimed to evaluate risk factors for local relapse (LR) and lymph node metastasis (LNM) and their impact on progression-free survival (PFS).
  
  
  METHODS
  In a retrospective monocentric study, patients with BSC-HN treated between 1999 and 2011 were analyzed regarding clinical and histologic characteristics. Prognostic parameters for LR, LNM, and PFS were evaluated. In total, 89 patients (55 male, 34 female, mean age of 71.8 years) with a mean follow-up time of 47.7 months (range 12-112) were included.
  
  
  RESULTS
  LR occurred in four patients (4.5%), LNM occurred in five patients (5.6%). Patients with LNM had a significantly shorter PFS time (16.1 months) compared with patients without LNM (154.2 months; P < .001). Tumor depth and size (T classification), incomplete resection, localization at the ear, deep maximal vertical infiltration, muscle and vessel invasion all showed significant (P < .05) associations with LR, LNM, and shorter PFS time. BSC showed more histologic features of basal cell carcinoma (BCC), especially with regard to BerEP4 expression.
  
  
  CONCLUSIONS
  While histology shows some typical characteristics of BCC, the biologic behavior and aggressiveness of BSC are similar to those of cutaneous squamous cell carcinoma. This is the first study to show that LR and, especially, LNM indicate a higher risk of an unfavorable outcome.
authors: Fachklinik Hornheide, Head and Neck Cancer Centre, Department of Cranio-Maxillofacial Surgery, Münster, Germany. Electronic address: Kai.Wermker@fachklinik-hornheide.de.
authors: Kai
authors: K
authors: Wermker
authors: Fachklinik Hornheide, Head and Neck Cancer Centre, Department of Cranio-Maxillofacial Surgery, Münster, Germany.
authors: Nikola
authors: N
authors: Roknic
authors: Fachklinik Hornheide, Head and Neck Cancer Centre, Department of Cranio-Maxillofacial Surgery, Münster, Germany.
authors: Katharina
authors: K
authors: Goessling
authors: Fachklinik Hornheide, Head and Neck Cancer Centre, Department of Cranio-Maxillofacial Surgery, Münster, Germany.
authors: Martin
authors: M
authors: Klein
authors: Fachklinik Hornheide, Skin Cancer Centre, Department of Dermatology and Dermato-Histo-Pathology, Münster, Germany.
authors: Hans-Joachim
authors: HJ
authors: Schulze
authors: Fachklinik Hornheide, Skin Cancer Centre, Department of Dermatology and Dermato-Histo-Pathology, Münster, Germany.
authors: Christian
authors: C
authors: Hallermann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002281:Carcinoma, Basosquamous / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D055815:Young Adult