Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2025, Vol. 39 ›› Issue (2): 94-100.doi: 10.6040/j.issn.1673-3770.0.2023.216

• Original Article • Previous Articles     Next Articles

Clinical and prognostic analysis of spindle cell squamous carcinoma of pharynx

HUANG Jiali, LIU Ziqi, XU Juan, CHEN Xi, ZHANG Liqing, ZHOU Han   

  1. Department of Otolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, Jiangsu, China
  • Published:2025-03-26

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Abstract: Objective To investigate the clinicopathological features, diagnosis, treatment and prognosis of patients with spindle cell squamous carcinoma, in order to improve the level of diagnosis and treatment of this tumor. Methods Between 2014-2021, patients from the First Affiliated Hospital of Nanjing Medical University with spindle cell squamous cell carcinoma were analyzed alongside patient data from the SEER database of America retrospectively. The propensity score matching(PSM)analysis was performed between patients with spindle cell squamous cell carcinoma and those with squamous cell carcinoma in the SEER database, and Kaplan-Meier survival analysis was performed to analyze the difference in overall survival between the two groups. Chi-square test and Cox risk model were used to analyze the relationship between clinical risk factors and prognosis. Results All patients were male with an average age of 60, including 5 cases of hypopharynx and 2 cases of nasopharynx. The main treatment is surgery, accompanied by chemoradiotherapy. Survival analysis after PSM showed that the survival rate of spindle cell squamous carcinoma of pharynx was significantly worse than common squamous cell carcinoma(χ2=61.84, P<0.001). Univariate analysis showed that race, TNM stage, T stage and M stage were related to overall survival(P<0.05). Multivariate regression analysis showed that race and M stage were independent prognostic factors for patients with spindle cell squamous carcinoma of pharynx(P<0.05). Conclusion Spindle cell squamous carcinoma of pharynx is rarer than common squamous cell carcinoma with poor prognosis. Race and distant metastasis are important prognostic indicators. And comprehensive treatment mode, regular review and lifelong follow-up should be adopted for these patients.

Key words: Head and neck neoplasms, Pharynx, Spindle cell squamous cell carcinoma, Propensity score matching, Prognostic factor analysis

CLC Number: 

  • R766
[1] Rotsides JM, Patel E, Oliver JR, et al. Non-squamous cell malignancies of the larynx[J]. Laryngoscope, 2022, 132(9): 1771-1777. doi:10.1002/lary.30007
[2] Rosko AJ, Birkeland AC, Wilson KF, et al. Tumor biomarkers in spindle cell variant squamous cell carcinoma of the head and neck[J]. Otolaryngol Head Neck Surg, 2016, 155(1): 106-112. doi:10.1177/0194599816636612
[3] Neha B, Shashi D, Seema R. Spindle cell squamous cell carcinoma of head and neck region: a clinicopathological and immunohistochemical study[J]. Indian J Surg Oncol, 2021, 12(4): 699-705. doi:10.1007/s13193-021-01418-1
[4] Palla B, Suhaym O, Majeed N, et al. Spindle cell variant squamous cell carcinoma of the oral cavity: case presentation and review of literature[J]. Oral Maxillofac Surg Cases, 2020, 6(3): 100174. doi:10.1016/j.omsc.2020.100174
[5] 王玉红, 王倩, 陈萍, 等. 原发于喉部的非鳞状细胞癌11例并文献复习[J]. 山东大学耳鼻喉眼学报, 2015, 29(1): 83-88.doi: 10.6040/j.issn.1673-3770.0.2014.302 WANG Yuhong, WANG Qian, CHEN Ping, et al. Clinical analysis of primary laryngeal non-squamous cell carcinoma(11 cases report)[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2015, 29(1): 83-88.10.6040/j.issn.1673-3770.0.2014.302
[6] Dai LY, Fang QG, Li P, et al. Oncologic outcomes of patients with sarcomatoid carcinoma of the hypopharynx[J]. Front Oncol, 2019, 9: 950. doi:10.3389/fonc.2019.00950
[7] Chen L, Chen Q, Li C, et al. Clinical analysis of laryngeal spindle cell carcinoma[J]. ORL J Otorhinolaryngol Relat Spec, 2020, 82(6): 310-317. doi:10.1159/000508134
[8] 姜超, 周炫辰, 韩杰, 等. IVc期下咽癌特征分析及列线图预后模型构建[J]. 山东大学耳鼻喉眼学报, 2022, 36(4): 49-54. doi:10.6040/j.issn.1673-3770.0.2021.278 JIANG Chao, ZHOU Xuanchen, HAN Jie, et al. Prevalence and prognostic nomogram for IVc stage hypopharyngeal carcinoma patients: a SEER popula-tion-based analysis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 49-54. doi:10.6040/j.issn.1673-3770.0.2021.278
[9] Fasunla AJ, Ogundoyin OA, Onakoya PA, et al. Malignant tumors of the larynx: Clinicopathologic profile and implication for late disease presentation[J]. Niger Med J, 2016, 57(5): 280-285. doi:10.4103/0300-1652.190596
[10] Chen HB, Gong XY, Li W, et al. Genomic landscape and tumor mutation burden analysis of Chinese patients with sarcomatoid carcinoma of the head and neck[J]. Oral Oncol, 2021, 121: 105436. doi:10.1016/j.oraloncology.2021.105436
[11] 田艳华, 苏凯, 王三春, 等. 咽喉部肉瘤样癌5例报告及文献复习[J]. 吉林大学学报(医学版), 2019, 45(3): 697-700. doi:10.13481/j.1671-587x.20190339 TIAN Yanhua, SU Kai, WANG Sanchun, et al. Sarcomatoid carcinoma of throat: a report of 5 cases and literature review[J]. Journal of Jilin University(Medicine Edition), 2019, 45(3): 697-700. doi:10.13481/j.1671-587x.20190339
[12] Ding L, Bi ZF, Yuan H, et al. Sarcomatoid carcinoma in the head and neck: a population-based analysis of outcome and survival[J]. Laryngoscope, 2021, 131(2): E489-E499. doi:10.1002/lary.28956
[13] 卢晶, 金仁顺. 咽喉部梭形细胞癌临床病理特点及免疫组织化学特征分析[J]. 临床耳鼻咽喉头颈外科杂志, 2018, 32(22): 1748-1750. doi:10.13201/j.issn.1001-1781.2018.22.016 LU Jing, JIN Renshun. Clinicopathological features and immunohistochemical characteristic analysis of spindle cell carcinoma of the larynx[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2018, 32(22): 1748-1750. doi:10.13201/j.issn.1001-1781.2018.22.016
[14] Dubal PM, Marchiano E, Kam D, et al. Laryngeal spindle cell carcinoma: a population-based analysis of incidence and survival[J]. Laryngoscope, 2015, 125(12): 2709-2714. doi:10.1002/lary.25383
[15] Bice TC, Tran V, Merkley MA, et al. Disease-specific survival with spindle cell carcinoma of the head and neck[J]. Otolaryngol Head Neck Surg, 2015, 153(6): 973-980. doi:10.1177/0194599815594360
[16] Duprez F, Berwouts D, De Neve W, et al. Distant metastases in head and neck cancer[J]. Head Neck, 2017, 39(9): 1733-1743. doi:10.1002/hed.24687
[17] Prieto-Granada CN, Xu B, Alzumaili B, et al. Clinicopathologic features and outcome of head and neck mucosal spindle cell squamous cell carcinoma[J]. Virchows Arch, 2021, 479(4): 729-739. doi:10.1007/s00428-021-03117-2
[18] Feng L, Cai D, Muhetaer A, et al. Spindle cell carcinoma: the general demographics, basic clinico-pathologic characteristics, treatment, outcome and prognostic factors[J]. Oncotarget, 2017, 8(26): 43228-43236. doi:10.18632/oncotarget.18017
[19] Spector ME, Wilson KF, Light E, et al. Clinical and pathologic predictors of recurrence and survival in spindle cell squamous cell carcinoma[J]. Otolaryngol Head Neck Surg, 2011, 145(2): 242-247. doi:10.1177/0194599811402167
[20] Dubal PM, Marchiano E, Kam D, et al. Laryngeal spindle cell carcinoma: a population-based analysis of incidence and survival[J]. Laryngoscope, 2015, 125(12): 2709-2714. doi:10.1002/lary.25383
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