Spindle cell carcinoma: the general demographics, basic clinico-pathologic characteristics, treatment, outcome and prognostic factors

// Lei Feng 1 , Deng Cai 2 , Alanuer Muhetaer 3 , Yin-Long Yang 4 , Fei Ren 5 , Mumingjiang Yishake 6 , Hao Zhang 7 , Yuan Fang 8 and Alimujiang Wushou 1 1 Department of Oral and Maxillofacial Surgery, Shanghai Stomatological Hospital, Fudan University, Shanghai 200001, China 2 Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China 3 Department of Gynaecology, Zhongshan Hospital, Fudan University, Shanghai 200000, China 4 Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China 5 Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai 200032, China 6 Department of Orthopedics Surgery, Zhongshan Hospital, Fudan University, Shanghai 200000, China 7 Department of Epidemiology and Biostatistics, Shanghai Stomatological Hospital, Fudan University, Shanghai 200001, China 8 Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200000, China Correspondence to: Alimujiang Wushou, email: wushoua@fudan.edu.cn Keywords: spindle cell carcinoma, SEER analysis, prognostic factors Received: February 20, 2017 Accepted: April 17, 2017 Published: May 19, 2017 ABSTRACT Background: Owing to the rarity, the general demographics, basic clinico-pathologic features, management, outcome and prognostic factors of spindle cell carcinoma (SpCC) were unexplored. Methods: A SEER analysis was performed with 2336 cases (1973-2016). Results: A peak incidence occurred at 70~80 years without any gender predominance and 83.13% occurred in white people. The respiratory system was mostly affected tumor site (35%). Significant overall survival (OS) and disease specific survival (DSS) were found differentiated in gender, age, marital status, primary tumor location, AJCC stage, T stage, N stage, M stage, pathologic grade and treatment modality. In the multivariate Cox model, the age > 69 years (Hazard ratio [HR] = 1.427 for OS, P = 0.01 and HR = 1.491 for DSS, P = 0.003; Reference [Ref] age ≤ 69 years), tumor location in respiratory system (HR = 1.550 for OS, P = 0.041 and HR = 1.561 for DSS, P = 0.04; Ref: digestive system), N2 stage (HR = 1.962 for OS, P = 0.006 and HR = 1.982 for DSS, P = 0.004; Ref: N0 stage) and AJCC stage IV (HR = 4.601 for OS, P = 0.000 and HR = 5.107 for DSS, P = 0.000; Ref: stage I) were independently associated with worse OS and DSS. Conclusions: SpCC mostly occurred in white people at 70~80 years old without predominance in any gender. The respiratory system was mostly affected site. The patient’s age, primary tumor location, AJCC stage were independent prognostic indicators for both DSS and OS of SpCC.