Ewing Sarcoma of the Head and Neck.

OBJECTIVES: Ewing sarcoma is a rare tumor of the head and neck. Previous efforts to characterize Ewing sarcoma of the head and neck (ES-HN) have been limited to small retrospective series. The objective of this study was to analyze the demographic, clinicopathologic, treatment, and survival characteristics of ES-HN compared to Ewing sarcoma at other locations (ES-other). METHODS: Using the Surveillance, Epidemiology, and End Results (SEER) database, we compared 183 patients with ES-HN to 3177 patients with ES-other. Patient characteristics were analyzed with chi-square or t test. Ten-year disease-specific survival (DSS) and overall survival (OS) were estimated via the Kaplan-Meier method and compared using the log-rank test. Multivariate Cox regression analysis was used to determine if HN location was an independent prognosticator. RESULTS: The ES-HN displayed a lower tumor size ( P < .001) and metastatic rate ( P < .001) compared to ES-other. The ES-HN had a better 10-year DSS and OS than ES-other ( P = .001, P = .015, respectively). The HN location did not achieve statistical significance on multivariate Cox regression analysis ( P = .88). CONCLUSION: ES-HN does not appear to be a separate clinical entity compared to ES-other; rather, its associated improved prognosis is likely secondary to its smaller size and lower metastatic rate compared to ES-other.

Head and neck chondrosarcomas: Analysis of the Surveillance, Epidemiology, and End Results database.

BACKGROUND: Chondrosarcoma is a rare tumor of the head and neck. Because of the limited clinical data, no studies have conducted a thorough comparison between head and neck chondrosarcomas and those arising at other body sites. METHODS: Using the Surveillance, Epidemiology, and End Results (SEER) database, we compared 682 patients with chondrosarcomas of the head and neck with 4757 patients with non-head and neck chondrosarcomas, evaluating disease-specific survival (DSS) and overall survival (OS) based on tumor location, histology, grade, stage, and treatment. RESULTS: Head and neck chondrosarcomas displayed a lower grade (p < .001) and stage (p < .0001) compared with other chondrosarcomas. Overall, chondrosarcomas of the head and neck had significantly higher DSS and OS than non-head and neck chondrosarcomas (p < .001). CONCLUSION: Chondrosarcomas of the head and neck display a lower grade and stage compared with other chondrosarcomas. DSS and OS were significantly greater for chondrosarcomas of the head and neck. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1359-1366, 2016.

Factors influencing survival in acinic cell carcinoma: a retrospective survival analysis of 2061 patients.

BACKGROUND: Acinic cell carcinoma is an uncommon salivary neoplasm with clinical and histologic features known to influence prognosis. The purpose of this study was to further describe variables influencing survival in a large cohort of patients with acinic cell carcinoma. METHODS: Using the Surveillance, Epidemiology, and End Results (SEER) registry, we obtained demographic, clinicopathologic, and treatment data pertaining to patients diagnosed with acinic cell carcinoma. Kaplan-Meier and Cox regression analyses were performed to compare survival with various clinical and pathological parameters. RESULTS: We identified 2061 patients with acinic cell carcinoma from 1973 to 2009. Sex, staging, grade, subsite, and treatment were significant predictors of disease-specific survival (DSS). Patients who received surgery alone had the highest 20-year DSS (92.4%), followed by those treated with surgery and radiation (71.9%) or radiation alone (62.3%). CONCLUSION: Our results suggest that histologic grade is a stronger predictor of survival than TNM classification, survival after surgical resection alone is excellent, and adjuvant radiation may be of limited benefit

Case-control analysis of survival outcomes in sinonasal acinic cell carcinoma.

BACKGROUND: Acinic cell carcinoma (AciCC) is an uncommon malignant-epithelial salivary gland cancer. In very rare cases, this tumor may arise from sinonasal subsites, with only 19 cases described in the English-language literature. METHODS: We performed a retrospective analysis of 18 cases of AciCC, obtained from searching the Surveillance, Epidemiology, and End Results (SEER) database between 1973 and 2009. RESULTS: Patient demographics, including age, gender, and race, were similar to AciCC cases found in more common locations. However, all patients had low-grade tumors without regional or distant metastases. Comparing these patients to a stage, grade, and treatment-matched cohort of parotid AciCC, we found a lower 10-year overall survival (52.3%) with no significant difference in disease-specific survival (88.9%). Our meta-analysis of survival from cases in the literature estimated 10-year recurrence-free survival at 92.9%. CONCLUSION: To our knowledge, this is the largest cohort of patients with AciCC reported in the English-language literature. Our results suggest that patients with sinonasal AciCC have excellent disease-specific survival, comparable to matched patients with AciCC in more common salivary gland subsites.

Basaloid squamous cell carcinoma of the oral cavity: an analysis of 92 cases.

OBJECTIVES/HYPOTHESIS: Basaloid squamous cell carcinoma (BSCC) is considered a rare and possibly more aggressive squamous cell carcinoma (SCC) variant. Until now, a series of exclusively oral cavity BSCC patients has not been previously reported. We endeavored to compare BSCC and SCC of the oral cavity, focusing on epidemiologic factors and survival outcomes. STUDY DESIGN: Retrospective analysis of population-based data. METHODS: We compared epidemiologic factors, clinicopathologic data, and disease-specific survivals (DSS) between 92 patients with oral cavity BSCC and 15,181 patients with SCC. RESULTS: High-grade tumors and distant metastases were more common in the BSCC group (P≤0.001). On multivariable analysis controlling for disease stage, BSCC patients had similar DSS to those with typical SCC (P=0.231). Although there was a trend favoring definitive radiotherapy for BSCC, there were no significant differences in treatment approach between BSCC and SCC. The choice of treatment modality (radiation, surgery±radiation) did not reveal a difference in DSS between the two tumor subtypes. CONCLUSION: Analysis of the largest oral cavity BSCC series to date demonstrates that BSCC of the oral cavity carries a comparable prognosis to conventional-type oral SCC. LEVEL OF EVIDENCE: 2b.