Distant metastasis in head and neck squamous cell carcinoma variants: A population-based study

Area of Science:

• Oncology
• Cancer Research
• Epidemiology

Background:

• Head and neck squamous cell carcinoma (HNSCC) with distant metastasis (DM) is associated with poor patient prognosis.
• HNSCC exhibits diverse histological variants, each potentially possessing unique clinical characteristics.
• Understanding these variations is crucial for accurate prognostication and treatment planning.

Purpose of the Study:

• To investigate the rates of distant metastasis (DM) among different histological variants of HNSCC.
• To compare the prognoses of patients with DM across these HNSCC variants.
• To identify HNSCC variants with a higher propensity for metastasis and poorer survival outcomes.

Main Methods:

• Utilized data from 54,722 cases from the Surveillance, Epidemiology, and End Results (SEER) database.
• Employed logistic regression models to estimate odds ratios (ORs) for DM.
• Applied Cox proportional hazard models to determine hazard ratios (HRs) for overall survival (OS).

Main Results:

• Distant metastasis (DM) rates varied significantly, ranging from 0.2% in verrucous carcinoma to 9.4% in basaloid squamous cell carcinoma (BSCC).
• Adenosquamous carcinoma (OR, 3.63), BSCC (OR, 6.80), and spindle cell carcinoma (SpCC) (OR, 3.91) showed increased odds of DM.
• Spindle cell carcinoma (SpCC) was significantly linked to a poorer overall survival (OS) (HR, 1.61).

Conclusions:

• Significant differences in DM rates exist among HNSCC histological variants.
• Spindle cell carcinoma (SpCC) with distant metastasis presents a worse prognosis compared to other metastatic HNSCC subtypes.
• These findings highlight the importance of considering histological variants in the management of metastatic HNSCC.