(A623) Risk Profiles in Pleomorphic Dermal Sarcoma of Head and Neck: Focus on Demographics and Comorbidities

Introduction: Pleomorphic dermal sarcoma (PDS) is a rare cutaneous malignancy associated with significant morbidity. This study explores the impact of demographic factors and comorbidities on the development and recurrence risk of PDS.

Methods: A retrospective review was conducted using institutional records from 2016–2024, identifying patients coded under ICD-10 C49.9 ("Malignant neoplasm of connective and soft tissue, unspecified") and patients of our 3 Head & Neck surgeons at our institution. Of 194 patients screened, 16 with confirmed PDS diagnoses were included. Data on demographics, comorbidities, tumor characteristics, treatments, and recurrence outcomes were collected and validated by two independent reviewers.

Results: The cohort (mean age 78, M:F ratio 7:1) demonstrated high prevalence of comorbidities, including history of other cancers (93.8%), hypertension (75%), obesity (37.5%), thrombotic disorders (31.3%), chronic kidney disease (31.3%), obstructive sleep apnea (25%), solid organ transplant history (25%), and anxiety (25%). Tobacco and alcohol use were reported by 43.8% and 31.3%, respectively. Metastasis occurred in 37.5% and local recurrence in 12.5%. Notably, a history of solid organ transplantation significantly increased the odds of recurrence or metastasis (OR = 24, 95% CI [1.02–580], p = 0.048). The overall mortality rate was 25%, with all deaths attributed to PDS-related complications or metastasis.

Conclusions: Comorbid conditions, particularly a history of tobacco use, other cancers, and solid organ transplantation, are linked to worse outcomes in PDS patients. These findings underscore the need for tailored management strategies for high-risk populations.