Clinical presentation and pattern of care for sarcomatoid variant of squamous cell carcinoma of the head-and-neck region

Abstract

Background: The sarcomatoid variant of squamous cell carcinoma (SCC) is an uncommon variant of head-and-neck cancer with a clinically aggressive course and poor outcomes. The data on the clinical presentation and pattern of treatment received by patients with sarcomatoid variant of SCC are scarce. Objectives: In this study, we aimed to assess the clinical presentation, intent of treatment, and the subsequent treatment-related outcomes of patients with sarcomatoid variant of SCC of the head-and-neck region. Materials and Methods: This retrospective study was conducted among treatment-naïve patients with sarcomatoid variant of SCC of the head-and-neck region who presented to the Tata Memorial Center, a tertiary care center, in Mumbai, India, between January 2012 and December 2018. The primary objective was to evaluate the stage at presentation and the intent of treatment received. The secondary outcome was disease-free survival (DFS). Variables were analyzed using simple descriptive statistical methods. DFS was calculated using the Kaplan–Meier method. Results: A total of 60 patients with sarcomatoid variant of SCC were included in the study. The median age of the patients was 51 years, with a male-to-female ratio of 5:1. The oral cavity was the most common subsite, reported in 39 (65%) patients. A total of 43 (71.6%) patients presented with advanced-stage disease, and 41 (68.3%) received curative-intent treatment. The DFS of patients who received curative treatment was 76.3 months (95% confidence interval [CI], 60.3–92.4) and that of patients who received palliative-intent treatment was 11.6 months (95% CI, 9.2–14). Conclusions: Sarcomatoid variant of SCC of the head-and-neck region usually presents with advanced-stage disease, however, has a reasonable DFS when treated appropriately with curative intent.