Basaloid squamous cell carcinoma of the head and neck: location means everything.

Background And Objectives: Head and neck basaloid squamous cell carcinoma (BSCC) is increasingly recognized as a malignancy with an evolving duel behavior. Our objective was to describe the site-specific presentation and prognosis of head and neck BSCC in comparison to conventional-type squamous cell carcinoma (SCC) using population-based data.

Methods: A total of 1,083 BSCC patients and 66,929 conventional-type SCC patients, diagnosed between 2000 and 2008, were identified using the Surveillance, Epidemiology, and End Results database. Clinicopathologic data were compared using χ(2) analysis. Kaplan-Meier analysis was used to estimate site-stratified disease-specific survival (DSS). BSCC's independent effect on DSS was assessed by multivariable regression analysis.

Results: The oropharynx (61.9%) was the most frequent BSCC site; compared to the larynx (33.3%) in conventional-type SCC. More BSCC patients presented with advanced-stage disease (78.4% vs. 60.1%, P < 0.001). On multivariable analysis, DSS was significantly better in the BSCC group when tumors were located in the oropharynx. Conversely, DSS was worse for BSCC patients with laryngeal tumors. DSS was similar among patients with sinonasal, nasopharyngeal, hypopharyngeal, and oral tumors.

Conclusions: BSCC's propensity for advanced-stage presentation was confirmed in this study. However, BSCC appears to carry a paradoxically similar, or better, prognosis compared to conventional-type SCC in most cases.