Tapan D Patel1, Alejandro Vázquez1, Max A Plitt1, Soly Baredes2, Jean Anderson Eloy3. 1. Department of Otolaryngology, Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ. 2. Department of Otolaryngology, Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ; Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, NJ. 3. Department of Otolaryngology, Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ; Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, NJ; Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, NJ. Electronic address: jean.anderson.eloy@gmail.com.
Abstract
PURPOSE: Carcinosarcoma is a rare malignant tumor of mixed epithelial and mesenchymal origin. In the head and neck, carcinosarcoma most commonly affects the salivary glands. Primary sinonasal carcinosarcoma (SN-CS) is exceedingly rare. METHODS: We performed a retrospective analysis of 15 cases of SN-CS obtained from the Surveillance, Epidemiology and End Results (SEER) database from 1973 to 2010. Case-matched cohorts of non-sinonasal carcinosarcoma (NS-CS), salivary gland carcinosarcoma (SG-CS) and carcinosarcoma at all other head and neck sites (NonSNSG-CS) were used for comparison. RESULTS: Women made up 60.0% of the SN-CS cohort and whites 73.3%. Tumors originated in the nasal cavity in 46.7% of cases, and from the maxillary sinus in 33.3%. In 66.7% of cases, tumors were poorly differentiated (histologic grades III and IV). Surgery with radiotherapy was the primary treatment modality in 46.7% of cases. Five-year disease-specific survival (DSS) was 48.5% for SN-CS compared to 65.5% for the case-matched SG-CS cohort (p = 0.2950), whereas it was 76.9% for the case-matched NonSNSG-CS cohort (p =0.0406). CONCLUSION: SN-CS is a rare tumor. Here we present the largest known cohort of SN-CS and report on its demographic, clinicopathologic and survival features. Our results suggest that patients with SN-CS have DSS comparable to the case-matched cohort of SG-CS patients. However, SN-CS patients have significantly poor survival outcomes compared to the case-matched cohort of NonSNSG-CS patients.
PURPOSE:Carcinosarcoma is a rare malignant tumor of mixed epithelial and mesenchymal origin. In the head and neck, carcinosarcoma most commonly affects the salivary glands. Primary sinonasal carcinosarcoma (SN-CS) is exceedingly rare. METHODS: We performed a retrospective analysis of 15 cases of SN-CS obtained from the Surveillance, Epidemiology and End Results (SEER) database from 1973 to 2010. Case-matched cohorts of non-sinonasal carcinosarcoma (NS-CS), salivary gland carcinosarcoma (SG-CS) and carcinosarcoma at all other head and neck sites (NonSNSG-CS) were used for comparison. RESULTS:Women made up 60.0% of the SN-CS cohort and whites 73.3%. Tumors originated in the nasal cavity in 46.7% of cases, and from the maxillary sinus in 33.3%. In 66.7% of cases, tumors were poorly differentiated (histologic grades III and IV). Surgery with radiotherapy was the primary treatment modality in 46.7% of cases. Five-year disease-specific survival (DSS) was 48.5% for SN-CS compared to 65.5% for the case-matched SG-CS cohort (p = 0.2950), whereas it was 76.9% for the case-matched NonSNSG-CS cohort (p =0.0406). CONCLUSION:SN-CS is a rare tumor. Here we present the largest known cohort of SN-CS and report on its demographic, clinicopathologic and survival features. Our results suggest that patients with SN-CS have DSS comparable to the case-matched cohort of SG-CSpatients. However, SN-CSpatients have significantly poor survival outcomes compared to the case-matched cohort of NonSNSG-CSpatients.
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