Survival with Spindle Cell Carcinoma Compared to Conventional Squamous Cell Carcinoma

Abstract

Objectives: (1) Compare survival of patients with spindle cell carcinoma variant (SpCC) to survival of patients with conventional squamous cell carcinoma (SCC). (2) Describe the impact of patient demographics and tumor characteristics on survival with SpCC. Methods: A retrospective cohort study was conducted with 18,416 cases entered into the Surveillance, Epidemiology, and End Results Program database between 2004 and 2009. Variables including age, sex, race, tumor grade, size, stage group, TNM stage, and treatment modality of 18,298 SCC patients and 118 SpCC patients were extracted and combined into oral cavity, oropharynx, and larynx sites. Characteristics and survival of SpCC and SCC patients were compared in total and at each site. The effect of variables on survival with SpCC was assessed. Results: In total, SpCC patients experienced worse survival than conventional SCC patients ( P < .05). Overall, SpCC patient mortality was worse than SCC patients within the first 3 years ( P < .05) but was not different at 5 or 10 years. Of the 3 sites, survival was only significantly worse for SpCC patients within the oropharynx site ( P < .05). Survival of SpCC patients was worse with higher stage group and TNM stage (both P < .05), but did not differ by sex, race, or tumor grade. Conclusions: SpCC carries a worse prognosis than conventional SCC when located in the oropharynx. Survival with SpCC was associated with stage group and TNM stage, but was unaffected by sex, race, or grade.