{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T08:20:17Z","timestamp":1791534017378,"version":"4.3.4"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T00:00:00Z","timestamp":1661212800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Carcinosarcoma of the salivary gland is a rare malignant biphasic tumor. The present study investigates the epidemiology and clinical behavior of carcinosarcoma of the major salivary glands using the National Cancer Database (NCDB).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Historical cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>NCDB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All tumors were selected between 2004 and 2018. Patient demographics, tumor characteristics, treatments, and survival were analyzed. Cox regression analysis was performed in surgically treated patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 154 patients in the NCDB with carcinosarcoma of the salivary gland. Median age at diagnosis was 66 years (interquartile range, 55\u201076). Most patients were male (n = 92, 60%). The majority of tumors were in the parotid (n = 122, 79%), followed by submandibular gland (n = 21, 14%). The majority were high grade (n = 93, 95%), and a significant portion had locally advanced disease (pT3\u20104; n = 65, 62%). Nodal disease was present in more than one\u2010third (n = 35, 36%). The most common treatment was surgery with adjuvant radiotherapy (n = 75, 49%). With a median follow\u2010up of 36 months, the 3\u2010year overall survival was 57.6% (95% CI, 48.7%\u201068.0%). In univariable analysis, advanced pT stage, pN+ disease, and positive margins were associated with worse survival. In multivariable analysis, age (hazard ratio, 1.02; 95% CI, 1.01\u20101.04; <jats:italic>P<\/jats:italic> = .03) and pT stage (hazard ratio, 2.51; 95% CI, 1.27\u20104.95; <jats:italic>P<\/jats:italic> = .008) remained significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Carcinosarcoma is a rare salivary gland tumor that frequently presents at a locally advanced stage. Despite multimodality treatments, the outcomes are poor. In the absence of clinical trial data, these data from the NCDB could guide clinicians in the management of this rare disease.<\/jats:p><\/jats:sec>","DOI":"10.1177\/01945998221120646","type":"journal-article","created":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T12:02:10Z","timestamp":1661256130000},"page":"775-781","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Patterns of Care and Outcomes of Carcinosarcoma of the Major Salivary Glands"],"prefix":"10.1002","volume":"168","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8385-6119","authenticated-orcid":false,"given":"Abhinav","family":"Talwar","sequence":"first","affiliation":[{"name":"Feinberg School of Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses","family":"Tam","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology NYU Langone Health  New York City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Pathology NYU Langone Health  New York City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology NYU Langone Health  New York City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Persky","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery NYU Langone Health  New York City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alec","family":"Vaezi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery NYU Langone Health  New York City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Jacobson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery NYU Langone Health  New York City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babak","family":"Givi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery NYU Langone Health  New York City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940711600913"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0030-4220(67)90348-9"},{"issue":"6","key":"e_1_2_8_4_1","first-page":"721","article-title":"Parotid tumors: histopathology, clinical behavior, and end results","volume":"92","author":"Kirklin JW","year":"1951","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_8_5_1","article-title":"Carcinosarcoma of the salivary glands","volume":"9","author":"Ihrler S","year":"2022","journal-title":"Head and Neck Tumours"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/2324709616676590"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/jscr\/rjab361"},{"issue":"1","key":"e_1_2_8_8_1","first-page":"279","article-title":"Malignant mixed tumors of the salivary glands: a review","volume":"28","author":"Gnepp DR","year":"1993","journal-title":"Pathol Annu"},{"key":"e_1_2_8_9_1","unstructured":"National Cancer Database. 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