Patel Tapan D, Vázquez Alejandro, Plitt Max A, Baredes Soly, Eloy Jean Anderson
Department of Otolaryngology, Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ.
Department of Otolaryngology, Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ; Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, NJ.
Am J Otolaryngol. 2015 Mar-Apr;36(2):200-4. doi: 10.1016/j.amjoto.2014.10.031. Epub 2014 Oct 31.
Carcinosarcoma is a rare malignant tumor of mixed epithelial and mesenchymal origin. In the head and neck, carcinosarcoma most commonly affects the salivary glands. Primary sinonasal carcinosarcoma (SN-CS) is exceedingly rare.
We performed a retrospective analysis of 15 cases of SN-CS obtained from the Surveillance, Epidemiology and End Results (SEER) database from 1973 to 2010. Case-matched cohorts of non-sinonasal carcinosarcoma (NS-CS), salivary gland carcinosarcoma (SG-CS) and carcinosarcoma at all other head and neck sites (NonSNSG-CS) were used for comparison.
Women made up 60.0% of the SN-CS cohort and whites 73.3%. Tumors originated in the nasal cavity in 46.7% of cases, and from the maxillary sinus in 33.3%. In 66.7% of cases, tumors were poorly differentiated (histologic grades III and IV). Surgery with radiotherapy was the primary treatment modality in 46.7% of cases. Five-year disease-specific survival (DSS) was 48.5% for SN-CS compared to 65.5% for the case-matched SG-CS cohort (p = 0.2950), whereas it was 76.9% for the case-matched NonSNSG-CS cohort (p =0.0406).
SN-CS is a rare tumor. Here we present the largest known cohort of SN-CS and report on its demographic, clinicopathologic and survival features. Our results suggest that patients with SN-CS have DSS comparable to the case-matched cohort of SG-CS patients. However, SN-CS patients have significantly poor survival outcomes compared to the case-matched cohort of NonSNSG-CS patients.
癌肉瘤是一种罕见的具有上皮和间充质混合起源的恶性肿瘤。在头颈部，癌肉瘤最常累及唾液腺。原发性鼻窦癌肉瘤（SN-CS）极为罕见。
我们对1973年至2010年从监测、流行病学和最终结果（SEER）数据库中获取的15例SN-CS病例进行了回顾性分析。使用非鼻窦癌肉瘤（NS-CS）、唾液腺癌肉瘤（SG-CS）以及头颈部所有其他部位的癌肉瘤（NonSNSG-CS）的病例匹配队列进行比较。
SN-CS队列中女性占60.0%，白人占73.3%。46.7%的病例肿瘤起源于鼻腔，33.3%起源于上颌窦。66.7%的病例肿瘤分化差（组织学分级为III级和IV级）。46.7%的病例主要治疗方式为手术加放疗。SN-CS的5年疾病特异性生存率（DSS）为48.5%，而病例匹配的SG-CS队列的5年DSS为65.5%（p = 0.2950），病例匹配的NonSNSG-CS队列的5年DSS为76.9%（p = 0.0406）。
SN-CS是一种罕见肿瘤。在此我们展示了已知最大的SN-CS队列，并报告了其人口统计学、临床病理和生存特征。我们的结果表明，SN-CS患者的DSS与病例匹配的SG-CS患者队列相当。然而，与病例匹配的NonSNSG-CS患者队列相比，SN-CS患者的生存结果明显较差。
