Potential impact of human papilloma virus on survival of basaloid squamous carcinoma of the head and neck

// Christian Jacobi 1 , Isabelle Ayx 1 , Kristin Fritsche 1 , Guido Piontek 1 , Dieter Hoffmann 2 , Gregor Weirich 3 and Andreas Knopf 1 1 Department of Otorhinolaryngology, Technical University Munich, Munchen, Germany 2 Institute of Virology, Technische Universitat and Helmholtz Zentrum Munchen, Munchen, Germany 3 Institute of Pathology, Technical University Munich, Munchen, Germany Correspondence: Christian Jacobi, email: // Keywords : BSCC, basaloid squamous carcinoma, head and neck, survival, HPV Received : September 08, 2014 Accepted : December 12, 2014 Published : December 18, 2014 Abstract Objectives: 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). Conclusion: 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.