Sarcomatoid carcinoma in head and neck: A review of 30 years of experience - Clinical outcomes and reconstructive results

Nai Jen Chang, Dennis S. Kao, Li Yu Lee, John Wen Cheng Chang, Ming Mo Hou, Wee Leon Lam, Ming Huei Cheng

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

PROBLEM PRESENTED: Sarcomatoid carcinoma (SaCa) is a rare variant of squamous cell carcinoma (SCC) with sarcomatoid features. This study investigated the clinical presentation and outcomes of head and neck SaCa. In addition, reconstructive outcome for a subset of patients was also evaluated. STUDIES UNDERTAKEN: Seventy-eight SaCa cases including 72 men and 6 women were identified from 13,777 head and neck SCC cases. Clinical outcomes were evaluated based on locoregional control, distant metastases, and multivariate analyses. Reconstructive outcome was evaluated by flap survival rate. RESULT: Of the 78 cases, 71% (55) of cases were located in the oral mucosa; 64% (50) of patients were classified as T3 or T4 at the time of diagnosis. The 5-year survival was only 16%. Multivariate analysis revealed better outcomes only when the patient had a history of previous SCC. Forty-five patients underwent flap reconstruction, with 98% flap survival rate but the functional result varied because of the inevitable adjuvant radiotherapy and advanced stage of tumor. CONCLUSIONS: Sarcomatoid carcinoma is a different entity from the conventional SCC of the head and neck. Sarcomatoid carcinoma carries a poorer prognosis despite aggressive surgical intervention and concurrent adjuvant therapies. It remains a great challenge for clinical oncologists, and the optimal treatment strategy requires further studies. Free flap is still preferred for defect reconstruction but the design should be simplified to avoid complications.

Original languageEnglish (US)
JournalAnnals of Plastic Surgery
Volume71
Issue numberSUPPL.1
DOIs
StatePublished - Dec 2013

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Neck
Head
Carcinoma
Squamous Cell Carcinoma
Multivariate Analysis
Survival Rate
Adjuvant Radiotherapy
Free Tissue Flaps
Mouth Mucosa
Neoplasm Metastasis
Survival
Therapeutics
Neoplasms
Carcinoma, squamous cell of head and neck

Keywords

  • clinical outcome
  • head and neck cancer
  • reconstruction
  • sarcomatoid carcinoma
  • squamous cell carcinoma

ASJC Scopus subject areas

  • Surgery

Cite this

Sarcomatoid carcinoma in head and neck : A review of 30 years of experience - Clinical outcomes and reconstructive results. / Chang, Nai Jen; Kao, Dennis S.; Lee, Li Yu; Chang, John Wen Cheng; Hou, Ming Mo; Lam, Wee Leon; Cheng, Ming Huei.

In: Annals of Plastic Surgery, Vol. 71, No. SUPPL.1, 12.2013.

Research output: Contribution to journalArticle

Chang, Nai Jen ; Kao, Dennis S. ; Lee, Li Yu ; Chang, John Wen Cheng ; Hou, Ming Mo ; Lam, Wee Leon ; Cheng, Ming Huei. / Sarcomatoid carcinoma in head and neck : A review of 30 years of experience - Clinical outcomes and reconstructive results. In: Annals of Plastic Surgery. 2013 ; Vol. 71, No. SUPPL.1.
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