An NCDB analysis on the demographic, treatment, and survival of nonkeratinizing small cell squamous cell carcinoma.
Authors:
EUGENE MANU
EUGENE MANU
Type
Documents
Documents
Keywords
Nonkeratinizing,squamous cell carcinoma,malignant,Epithelial
Nonkeratinizing,squamous cell carcinoma,malignant,Epithelial
Date Created
2026-10-01 13:46:30
2026-10-01 13:46:30
Abstract
Nonkeratinizing small cell squamous cell carcinoma (NSCSCC), ICD-O-3 code-8073, is a malignant epithelial neoplasm composed of small, basaloid-appearing squamouscells with high nuclear-to-cytoplasmic ratios and minimal cytoplasmic keratinization, lackingkeratin pearl formation, retaining immunohistochemical evidence of squamous differentia-tion, and not exhibiting neuroendocrine features. Despite NSCSCC’s rarity, it accounts for 5% ofall squamous cell carcinomas (SCC). Given NSCSCC’s rarity, evaluating diagnostic trends mayprovide important insights into its epidemiology. Therefore, the National Cancer Database(NCDB) was analyzed to characterize demographic factors among patients diagnosed withNSCSCC. Methods: A retrospective cohort study using the 2004–2020 NCDB identified patientswith histologically confirmed NSCSCC (N = 934). Demographic and clinical variables includingage, sex, race, household income, survival rate, and treatment method—were summarizedusing descriptive statistics, and incidence trends were evaluated using regression analyses.Results: Between 2004 and 2020, 934 patients with SCNSCC were identified in the NCDB with adecreasing incidence (R2 = 0.33). The majority of patients are female (60.3%), with the racialbreakdown as follows: 84.5% White, 11.3% Black, and 4.2% Other. The mean age at diagnosis is64.6 years (SD = 0.442). Median household income for each patient is measured through therespective data for their zip code of residence, said data is then further categorized as quartilesbased on equally proportioned income ranges among all US zip codes; 21.1% of patients are in Q1( , $46,277), 23.9% in Q2 ($46,227 - $57,856), 25.1% in Q3 ($57,857 - $74,062), and 29.9% inQ4 ($74,063 or more). The most frequently observed primary sites is the upper lobe of the lung(27.7%), with the mean tumor size being 44.94mm (SD = 4.08). The majority of patients(62.5%) did not receive surgical procedures at the primary site, for those that did the vastmajority (79.9%) had no residual tumor as the surgical margin; additional primary treatmentmethods include, 49.3% received at least chemotherapy, 51.5% had radiation, 0.5% had hor-mone therapy, and 1.2% had immunotherapy. The 2-, 5-, and 10-year survival rates are 52.5%,37.0%, and 26.3%, respectively, with a mean survival time of 70.209 months (SD = 3.127).Conclusions: To our knowledge, this is the first NCDB analysis addressing SCNSCC, thusaddressing a significant knowledge gap on the topic. This analysis shows that SCNSCC mainlyaffects the elderly, with surgery, chemotherapy, and radiation being the common treatments,consistent with previous published work on SCC, the broader category that includes SCNSCC. Tobetter understand how demographic and socioeconomic factorsinfluence diagnosis, treatment,and survival in SCNSCC, further research is needed.
Nonkeratinizing small cell squamous cell carcinoma (NSCSCC), ICD-O-3 code-8073, is a malignant epithelial neoplasm composed of small, basaloid-appearing squamouscells with high nuclear-to-cytoplasmic ratios and minimal cytoplasmic keratinization, lackingkeratin pearl formation, retaining immunohistochemical evidence of squamous differentia-tion, and not exhibiting neuroendocrine features. Despite NSCSCC’s rarity, it accounts for 5% ofall squamous cell carcinomas (SCC). Given NSCSCC’s rarity, evaluating diagnostic trends mayprovide important insights into its epidemiology. Therefore, the National Cancer Database(NCDB) was analyzed to characterize demographic factors among patients diagnosed withNSCSCC. Methods: A retrospective cohort study using the 2004–2020 NCDB identified patientswith histologically confirmed NSCSCC (N = 934). Demographic and clinical variables includingage, sex, race, household income, survival rate, and treatment method—were summarizedusing descriptive statistics, and incidence trends were evaluated using regression analyses.Results: Between 2004 and 2020, 934 patients with SCNSCC were identified in the NCDB with adecreasing incidence (R2 = 0.33). The majority of patients are female (60.3%), with the racialbreakdown as follows: 84.5% White, 11.3% Black, and 4.2% Other. The mean age at diagnosis is64.6 years (SD = 0.442). Median household income for each patient is measured through therespective data for their zip code of residence, said data is then further categorized as quartilesbased on equally proportioned income ranges among all US zip codes; 21.1% of patients are in Q1( , $46,277), 23.9% in Q2 ($46,227 - $57,856), 25.1% in Q3 ($57,857 - $74,062), and 29.9% inQ4 ($74,063 or more). The most frequently observed primary sites is the upper lobe of the lung(27.7%), with the mean tumor size being 44.94mm (SD = 4.08). The majority of patients(62.5%) did not receive surgical procedures at the primary site, for those that did the vastmajority (79.9%) had no residual tumor as the surgical margin; additional primary treatmentmethods include, 49.3% received at least chemotherapy, 51.5% had radiation, 0.5% had hor-mone therapy, and 1.2% had immunotherapy. The 2-, 5-, and 10-year survival rates are 52.5%,37.0%, and 26.3%, respectively, with a mean survival time of 70.209 months (SD = 3.127).Conclusions: To our knowledge, this is the first NCDB analysis addressing SCNSCC, thusaddressing a significant knowledge gap on the topic. This analysis shows that SCNSCC mainlyaffects the elderly, with surgery, chemotherapy, and radiation being the common treatments,consistent with previous published work on SCC, the broader category that includes SCNSCC. Tobetter understand how demographic and socioeconomic factorsinfluence diagnosis, treatment,and survival in SCNSCC, further research is needed.