Abstract
OBJECTIVE
1) To determine clinicopathologic predictors of recurrence and survival in patients with spindle cell variant of squamous cell carcinoma (SpSCC). 2) To determine if patients with SpSCC have a higher locoregional control and survival than conventional squamous cell carcinoma (SCC).
METHOD
48 patients (mean age, 65.2 years; M:F, 35:13), who underwent definitive treatment for pathologically confirmed SpSCC between 1987 and 2009 were identified. Main outcome measures were time to recurrence, disease-specific survival and overall survival while controlling for clinical and pathologic parameters (TNM classification, stage, tumor subsite, smoking status, treatment modality, presence of an exophytic tumor).
RESULTS
Of 48 patients, there were 25 oral cavity, 15 larynx, 7 oropharynx, and 1 maxillary sinus tumors. Primary treatment included surgery in 32, radiation in 9, and concurrent chemoradiation in 7 patients. Overall survival was 66.6% (32/48) with a median follow-up of 59 months. 52.1% (25/48) of patients developed a recurrence; 22 of 25 recurred locally or locoregionally. Recurrence occurred within two years in 72% (18/25) of patients. Initial T and N classification, overall stage, tumor subsite, smoking status, and presence of an exophytic tumor were not predictive of recurrence or survival. Only gender (female) was predictive of a worse overall survival (7/13 vs 10/35, p<0.008) but not recurrence.
CONCLUSION
Patients with SpSCC are at high risk of developing locoregional recurrence, but overall survival is similar to conventional SCC. Closer follow-up should be considered in these patients to allow for earlier detection and treatment of these locally aggressive tumors.