A clinicopathologic analysis of PVL associated squamous cell carcinoma (p-scca) and its impact on a better short term survival

Objectives: The purpose of this study was to analyze the clinicopathologic features of squamous cell carcinoma arising in patients with a background of proliferative verrucous leukoplakia and to document and explain its impact on long and short term survival.
Methods: We retrospectively reviewed 15 PVL patients with multiple cases of p-scca (n=48) and 49 patients with conventional squamous cell carcinoma of the buccal mucosa, gingiva and palate who were treated and followed between 1990 and 2014. Histologic characteristics including the histologic risk score, clinical stage, margin status, and short/long term prognosis were documented. Immunohistochemistry was performed using antibodies directed against p16, p53 and ki67.
Results: The groups with p-scca and c-scca were comparable regarding age, gender, histologic grade (p = 0.3119), ki67 (p=0.6431) and p16 (p=0.8633) expression, surgical margin status and long-term survival (p=0.12). Significant differences included tumor thickness (p = 0.0001), histologic risk score (p=0.0004), p53 expression (p=0.0043), clinical stage (p=0.0001) and short term (4 year) survival (p=0.03).
Conclusions: Better prognostic factors and longer short term survival were associated with p-scca. We suggest that p-scca may represent a less aggressive and distinct clinical entity which may influence the treatment choice for these patients. Further studies on a larger cohort of patients are recommended.