Salivary Carcinosarcoma: An Extremely Rare and Highly Aggressive Malignancy

• Published in: The Laryngoscope 2020-05, Vol.130 (5), p.E335-E339
• Main Authors: Gupta, Avigeet, Koochakzadeh, Sina, Neskey, David M., Nguyen, Shaun A., Lentsch, Eric J.
• Format: Article
• Language: English
• Subjects: Carcinosarcoma; Exocrine glands; malignant mixed tumor; Medical prognosis; Mortality; Oral cancer; parotid gland; salivary malignancies; Survival analysis; Tumors
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.28183

Objectives/Hypothesis Carcinosarcomas represent a rare entity of mixed malignant tumors of the salivary gland with limited evidence regarding management strategies. We aim to demonstrate the incidence, prognostic factors, and conduct a survival analysis for this aggressive malignancy. Study Design Retrospective database review. Methods The Surveillance, Epidemiology, and End Results database was queried for all cases of major salivary carcinosarcoma and its incidence from 1973 to 2015 to identify 66 patients. Results The incidence of this tumor was 0.02 cases per 1 million, with a rising number of absolute cases in the past 2 decades. The parotid gland was the most common site (78.8%) of involvement. The 5‐year overall survival was 37% and 5‐year disease‐specific survival was 62%. Surgery was most common management strategy (95.5%), with total parotidectomy and facial nerve sacrifice procedures for those with parotid disease. Radiotherapy was commonly performed (75.8%) and chemotherapy use was rare (18.2%). Patients with distant metastasis had a greater than threefold increase in mortality, and those with total parotidectomy surgery had decreased mortality. Conclusions Carcinosarcomas of major salivary glands are extremely rare and highly aggressive tumors. We recommend prompt surgical management and postoperative radiation for this tumor with a poor prognosis. Level of Evidence NA Laryngoscope, 130:E335–E339, 2020