Intrinsic tumor cell characteristics as possible prognostic markers for extranodal expansion in head and neck squamous cell carcinoma

Introduction:

Especially for stage III and IV head and neck squamous cell carcinoma (HNSCC) it might be helpful to improve risk assessment in order to plan therapy through tissue biopsies and extended histopathological analysis in addition to clinical parameters and tumor grading. For this purpose, we investigated four histopathological characteristics in a representative cohort of patients concerning their potential eligibility to enhance the outcome predictability.

Methods:

For a retrospective cohort of 90 non-selected patients with stage III + IV HNSCC of all localizations the histopathological parameters basaloid features (BF), nuclear pleomorphism (NP), degree of keratinization (K) and lymphoplasmacytic reaction (LR) of the tumor tissue have been correlated with tumor stage, extranodal spread and patients' outcome. A standardized histopathological classification was performed.

Results:

The distribution of tumor stages III + IV is independent from the tissue characteristics. An extranodal tumor spread exists in 43,5% (10/23) of the cases with BF, in 27,6% (8/29) of the cases without K and in 21,9% (7/32) with mild K. Tumors without NP, without K, with BF or LR correlate with higher survival rates.

Conclusions:

Regarding our cohort, extranodal expansion of lymph node metastases occurred more frequently in tumors showing BF as well as tumors with no or only mild K, which might possibly indicate radical operative procedure in neck dissections. This study indicates that the histopathological characteristics basaloid features, nuclear pleomorphism, degree of keratinization and lymphoplasmacytic reaction may serve as additional outcome indicators to clinical features.

Publication History

Publication Date:
23 April 2019 (online)