title: Disease-Specific Survival with Spindle Cell Carcinoma of the Head and Neck.
abstract: OBJECTIVE
  (1) Determine factors influencing survival in patients diagnosed with spindle cell carcinoma (SpCC), a rare variant of head and neck squamous cell carcinoma (SCC). (2) Compare survival of patients with SpCC to those with conventional SCC.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Surveillance, Epidemiology, and End Results 18 database (years 2004-2009).
  
  
  METHODS
  Among patients receiving treatment for a single primary in the oral cavity, oropharynx, hypopharynx, or larynx, 118 subjects with SpCC and 18,298 subjects with SCC were identified with complete data for the variables of age, sex, grade, tumor size, stage group, and TNM stage. Disease-specific survival curves were compared. Univariate and multivariate analyses were used to examine the effects of each factor on survival over all sites and within each of 3 sites.
  
  
  RESULTS
  Univariate analysis of the combination of the 3 anatomic subsites showed survival with SpCC was worse than with conventional SCC (P < .001). Three-year disease-specific survival with SpCC was 49.5%, and 5-year disease-specific survival was 40.2%. Compared with conventional SCC, survival was worse for SpCC of the oral cavity (P < .001) and oropharynx (P < .001) but no different for the larynx and hypopharynx site (P = .15). Multivariate analysis identified age (P = .02), tumor size (P = .006), and M stage (P < .001) as the only variables significantly affecting survival with SpCC. All variables significantly affected survival with conventional SCC.
  
  
  CONCLUSIONS
  Spindle cell carcinoma carries a worse prognosis than SCC. Larger tumor size, older age, and metastatic disease portend worse survival with SpCC of the head and neck.
authors.affiliation: University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
authors.forename: Tristan C
authors.initials: TC
authors.lastname: Bice
authors.affiliation: Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Van
authors.initials: V
authors.lastname: Tran
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Merkley
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Shawn D
authors.initials: SD
authors.lastname: Newlands
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Paul G
authors.initials: PG
authors.lastname: van der Sloot
authors.affiliation: Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Shuang
authors.initials: S
authors.lastname: Wu
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, University of Rochester Medical Center, Rochester, New York, USA matthew_miller@urmc.rochester.edu.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Miller
mesh_terms: D000704:Analysis of Variance; D002277:Carcinoma / Q000401:mortality*; D002294:Carcinoma, Squamous Cell / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality; D007822:Laryngeal Neoplasms / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality; D015999:Multivariate Analysis; D009959:Oropharyngeal Neoplasms / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies
keywords: SEER; spindle cell carcinoma; squamous cell carcinoma; survival