Tumor Biomarkers in Spindle Cell Variant Squamous Cell Carcinoma of the Head and Neck

Objective To determine biomarkers of recurrence and survival in patients with spindle cell variant squamous cell carcinoma (SpSCC) of the head and neck. Study Design Retrospective case control study. Setting Tertiary academic center. Subjects and Methods Thirty-two SpSCC patients (mean age, 68.8) between 1987 and 2009 were identified and reviewed. A tissue microarray (TMA) was constructed from tumor specimens. Tumor biomarkers under study included p16, epidermal growth factor receptor (EGFR), p53, EZH2, cyclin D1, CD104, HGFa, p21, and cMET. An additional TMA was constructed from patients with non-SpSCC oral cavity squamous cell carcinoma for comparative purposes. The main outcomes were overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS). Results In the SpSCC cohort, tumors positive for cMet had worse OS (P <.001). Patients positive for cMet (P =.007), cyclin D1 (P =.019), and p16 (P =.004) had worse DSS. Recurrence-free survival was also worse in patients with tumors positive for cMet (P =.037), cyclin D1 (P =.012), and p16 (P <.001). Compared with the oral cavity cohort, there was a significantly larger proportion of patients in the SpSCC group with tumors staining positive for cMet and a lower proportion of tumors positive for cyclin D1. Conclusion cMet, cyclin D1, and p16 are predictive tumor biomarkers for risk of recurrence and worse DSS in patients with SpSCC.