title: Population-based analysis of prognostic indicators in sebaceous carcinoma of the head and neck.
abstract: OBJECTIVE
  Due to the rarity of sebaceous carcinoma of the head and neck, few large series have been reported and prognostic factors remain largely undetermined. This study presents prognostic factors in survival in sebaceous carcinoma of the head and neck.
  
  
  METHODS
  Retrospective analysis was performed using the Surveillance Epidemiology and End Results (SEER) database for patients diagnosed with sebaceous carcinoma of the head and neck (SCHN).
  
  
  METHODS
  Clinicopathologic, treatment data, and 5-year disease specific survival were analyzed using univariable and multivariable regression analysis and Kaplan-Meier methodology.
  
  
  RESULTS
  Of the 1,433 patients identified to have SCHN, 16 were node-positive (1.14%). On multivariable analysis, independent prognostic indicators were: age at diagnosis (HR = 1.03, P = .021), tumor grade (HR = 4.97, P = .038), and distant metastasis (HR = 7.52, P = .006). Nodal metastasis occurred exclusively with poorly or undifferentiated tumors and was not a significant prognostic factor on multivariable analysis.
  
  
  CONCLUSIONS
  Elderly patients and patients with poorly differentiated tumors and/or distant disease at presentation have the highest risk of disease-specific mortality. Lymph node metastasis does not appear to be an independent prognostic factor in sebaceous cell carcinoma.
authors.affiliation: College of Medicine, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
authors.forename: W Walsh
authors.initials: WW
authors.lastname: Thomas
authors.forename: Valerie A
authors.initials: VA
authors.lastname: Fritsch
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Lentsch
mesh_terms: D018266:Adenocarcinoma, Sebaceous / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001707:Biopsy, Needle; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018426:SEER Program; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
keywords: SEER database; Sebaceous carcinoma; head and neck; prognostic factors