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.
Keywords: Carcinosarcoma; malignant mixed tumor; parotid gland; salivary malignancies.
© 2019 The American Laryngological, Rhinological and Otological Society, Inc.