title: Spindle cell carcinoma of the head and neck region: treatment and outcomes of 15 patients.
abstract: BACKGROUND
  Spindle cell carcinoma of the head and neck is a rare entity and the evidence of optimal management is lacking. The objective of our study was to report the treatment and outcomes of 15 patients treated in a single institution over a seven year period.
  
  
  METHODS
  A total of 15 patients (12 males and 3 females) with spindle cell carcinoma of the head and neck were treated between July 2007 to June 2014. In six patients the disease developed after previous radiotherapy. Of the 15 patients, five patients had their primary in the tongue, four in the paranasal sinuses, two in the hypopharynx, two in the vocal cords, and one each in the soft palate and the floor of mouth. Eleven patients were treated with radical intent (seven patients required surgery only and four were treated with combined modality). The remaining four patients were treated with palliative intent.
  
  
  RESULTS
  Among 11 patients treated with radical intent eight are alive or died of non-oncological causes. The disease recurred locally in three patients and they died of the disease (two patients with locally advanced disease in the tongue and one patient with T1N0 tumour in the hypopharynx). Median overall survival (OS) was 18 months.
  
  
  CONCLUSIONS
  Surgery or surgery combined with radiotherapy has a real impact on the natural cause of spindle cell carcinoma of the head and neck region. Even locally advanced tumours can be controlled with aggressive treatment. The worst outcome is seen with the tongue as the primary site because of a high local recurrence rate.
authors.affiliation: Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK.
authors.forename: Muhammad Shahid
authors.initials: MS
authors.lastname: Iqbal
authors.affiliation: Department of Head and neck surgery, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK.
authors.forename: Vinidh
authors.initials: V
authors.lastname: Paleri
authors.affiliation: Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK.
authors.forename: Jolene
authors.initials: J
authors.lastname: Brown
authors.affiliation: Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK.
authors.forename: Alastair
authors.initials: A
authors.lastname: Greystoke
authors.affiliation: Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK.
authors.forename: Werner
authors.initials: W
authors.lastname: Dobrowsky
authors.affiliation: Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK.
authors.forename: Charles
authors.initials: C
authors.lastname: Kelly
authors.affiliation: Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK.
authors.forename: Josef
authors.initials: J
authors.lastname: Kovarik
keywords: head and neck cancer; radiotherapy; spindle cell carcinoma; surgery