Prognostic factors for adult sarcomas of head and neck

Int J Oral Maxillofac Surg. 2008 May;37(5):428-32. doi: 10.1016/j.ijom.2008.01.019. Epub 2008 Mar 14.

Abstract

The optimal management of adult soft-tissue sarcomas is not clearly established. To assess prognostic factors and survival, the experience of 45 recent successive cases was reviewed. Data were collected from a retrospective database (1993-2005) and statistically analyzed. Rhabdomyosarcomas were excluded. The mean age was 50.1 years; there were 24 men and 21 women. The main histological subtypes were undifferentiated sarcoma (14) and angiosarcoma (10); 21 tumours were grade 3 (46%). The most frequent primary sites were neck muscles (15, 33%) and scalp (11, 24%). At presentation, 5 (20%) cases with lymph-node involvement and another 11 cases (24%) with distant metastasis were observed. The treatment was with curative intent in 33 cases (73%). This entailed surgery, with adjuvant radiotherapy in 15 cases and adjuvant chemotherapy in 5 cases. The 5-year overall survival was 52% (+/-8%). In univariate analysis, the poor prognostic factors were high grade, initial metastasis or lymph nodes, absence of surgery, and number of surgical procedures. In multivariate analysis, two factors remained significant: grade (P=0.006) and absence of surgery (P=0.005). After taking into account grade and metastasis at presentation, quality of surgery has prognostic value. The primary aim of a multidisciplinary approach to these tumours must favour complete resection.

MeSH terms

  • Analysis of Variance
  • Chemotherapy, Adjuvant
  • Disease-Free Survival
  • Female
  • Head and Neck Neoplasms* / drug therapy
  • Head and Neck Neoplasms* / pathology
  • Head and Neck Neoplasms* / rehabilitation
  • Head and Neck Neoplasms* / surgery
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Prognosis
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Sarcoma* / drug therapy
  • Sarcoma* / pathology
  • Sarcoma* / rehabilitation
  • Sarcoma* / surgery
  • Soft Tissue Neoplasms* / drug therapy
  • Soft Tissue Neoplasms* / pathology
  • Soft Tissue Neoplasms* / rehabilitation
  • Soft Tissue Neoplasms* / surgery
  • Surgical Procedures, Operative / statistics & numerical data