Clinicopathological analysis and survival outcomes of head and neck spindle cell carcinoma: A systematic review.

BACKGROUND

This systematic review aimed to summarize the clinicopathological characteristics, molecular profile, treatment, and outcomes of head and neck spindle cell carcinoma (HNSpCC).

METHODS

A comprehensive search was performed in five databases and gray literature (December 2024). Associations between clinical variables were tested using Fisher's exact and Chi-square tests, and survival was analyzed with the Kaplan-Meier method.

RESULTS

Thirty-nine studies reporting 2,250 cases were included. HNSpCC primarily affects adult males, with the larynx being the most common site, followed by the oral cavity and oropharynx, often presenting as polypoid/exophytic tumors. Diagnosis requires careful use of immunohistochemistry, especially vimentin and epithelial markers. Genetic alterations included TP53, EGFR, ALK, and PIK3CA mutations. Surgery was the main treatment; however, local recurrences, regional and distant metastases were frequent. Survival outcomes were influenced by tumor site, stage, and recurrence. Oral cavity tumors showed the worst prognosis, while laryngeal tumors had comparatively better survival.

CONCLUSIONS

HNSpCC is an aggressive malignancy with poor outcomes, especially in advanced-stage and oral cavity cases.