Population-based analysis of prognostic indicators in sebaceous carcinoma of the head and neck.

OBJECTIVES/HYPOTHESIS: Due to the rarity of sebaceous carcinoma of the head and neck, few large series have been reported and prognostic factors remain largely undetermined. This study presents prognostic factors in survival in sebaceous carcinoma of the head and neck.

STUDY DESIGN: Retrospective analysis was performed using the Surveillance Epidemiology and End Results (SEER) database for patients diagnosed with sebaceous carcinoma of the head and neck (SCHN).

METHODS: Clinicopathologic, treatment data, and 5-year disease specific survival were analyzed using univariable and multivariable regression analysis and Kaplan-Meier methodology.

RESULTS: Of the 1,433 patients identified to have SCHN, 16 were node-positive (1.14%). On multivariable analysis, independent prognostic indicators were: age at diagnosis (HR = 1.03, P = .021), tumor grade (HR = 4.97, P = .038), and distant metastasis (HR = 7.52, P = .006). Nodal metastasis occurred exclusively with poorly or undifferentiated tumors and was not a significant prognostic factor on multivariable analysis.

CONCLUSION: Elderly patients and patients with poorly differentiated tumors and/or distant disease at presentation have the highest risk of disease-specific mortality. Lymph node metastasis does not appear to be an independent prognostic factor in sebaceous cell carcinoma.