title: Adenosquamous Carcinoma of the Head and Neck: A Case-Control Study with Conventional Squamous Cell Carcinoma.
abstract: Adenosquamous carcinoma (AdSC) is considered a rare variant of squamous cell carcinoma (SCC) which is considered to be more clinically aggressive. Data is very limited with very little case matched data on outcomes in the literature. It is also unknown whether the quantity of the adenocarcinoma component affects outcomes. A retrospective case-control study with 23 cases of AdSC and 1137 SCC controls was conducted. Cases were matched by anatomic subsite, treatment, and, for oropharynx, by p16 status. The following variables were adjusted for in the analysis: T classification (T1/T2 vs. T3/T4), N classification (N0-N2a vs. N2b-N3), age, and smoking. The adenocarcinoma component was quantified by the number of high power fields containing glands as low, moderate, or high. AdSCs had a significantly greater risk of disease recurrence but largely, the differences were not statistically significant. The quantity of adenocarcinoma did not correlate with disease recurrence or survival. This case-control study on AdSC shows modestly more clinically aggressive behavior than conventional SCC, even while controlling for p16 status for oropharyngeal cases. Further, it suggests the current definition of AdSC, with no minimum requirement for gland formation, is clinically accurate.
authors.affiliation: School of Medicine, Pathology and Immunology, Washington University in St. Louis, St. Louis, MO, USA.|Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Mitra
authors.initials: M
authors.lastname: Mehrad
authors.affiliation: School of Medicine, Biostatistics, Washington University in St. Louis, St. Louis, MO, USA.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Trinkaus
authors.affiliation: School of Medicine, Pathology and Immunology, Washington University in St. Louis, St. Louis, MO, USA. james.lewis@vanderbilt.edu.|School of Medicine, Otolaryngology - Head and Neck Surgery, Washington University in St. Louis, St. Louis, MO, USA. james.lewis@vanderbilt.edu.|Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, 1211 Medical Center Drive, Room 3020D - Surgical Pathology, Nashville, TN, 37232-7415, USA. james.lewis@vanderbilt.edu.|Otolaryngology, Vanderbilt University Medical Center, Nashville, TN, USA. james.lewis@vanderbilt.edu.
authors.forename: James S
authors.initials: JS
authors.lastname: Lewis
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D018196:Carcinoma, Adenosquamous / Q000401:mortality / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology*; D016022:Case-Control Studies; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D000077195:Squamous Cell Carcinoma of Head and Neck
chemical_list: D014408:Biomarkers, Tumor
keywords: Adenosquamous carcinoma; Case control; Head and neck; Squamous cell carcinoma; Survival