Head and neck sarcomas: the UCLA experience

Abstract

Purpose To profile the clinical presentation, subtype distribution, and treatment results of sarcomas of the head and neck at a single tertiary academic center over an 11-year period. Materials and Methods A retrospective review was performed by examining the records and reviewing the pathology of 186 patients with head and neck sarcomas treated at UCLA Medical Center from 2000 to 2011. Results The mean age of the study population was 49 +/− 22 years. 58% of the patients were male and 42% were female. Median duration of follow-up for the entire group was 18.5 months. The most common presenting symptom was a mass lesion in 59.9% of patients. The nasal cavity/sinus was the most common presenting site seen in 22% of patients. Solitary fibrous tumor/hemangiopericytoma was the most common subtype. 15% of patients had evidence of prior radiation exposure. 26.3% of tumors were greater than 5cm and 35.5% were high-grade. Margins were positive in 31.2% of patients. Lymph node metastasis was rare at 6.5%. Perineural invasion was identified in 6.5%. Among all subtypes, 5-yr recurrence-free survival and overall survival were 50% and 49%, respectively. Multivariate analysis demonstrated that grade and margin status were predictors of recurrence-free survival while grade and age affected overall survival. Conclusions Head and neck sarcomas are a rare entity frequently presenting as a mass lesion. In our series, lesions tended to be high-grade with a significant portion of surgical specimens having positive margins. Grade and margin status were the most important predictors of survival.

Low-Grade Fibromyxoid Sarcoma of the Head and Neck: A Clinicopathologic Series and Review of the Literature

“…Notably, several recent larger series of LGFMS did not identify any cases in the head and neck region [4,5]. Many authors did not specify the location beyond ''head/neck''.…”

“…Some of the most frequently encountered sarcomas include rhabdomyosarcoma and Ewing sarcoma in children and young adults, and rhabdomyosarcoma, synovial sarcoma, Kaposi sarcoma, and angiosarcoma in older adults [2,3]. Primary head and neck sarcomas commonly involve the scalp, face, and nasal cavity, while the larynx and upper airway are more unusual sites [1,4,5]. The prognosis is related to the tumor type and extent of resection, which is often incomplete due to anatomic restrictions [5].…”

Prognostic factors of head and neck sarcomas

“…We read with great interest the recent article by Tajudeen et al [1] who claimed that their study was "the first report of predictors of survival and recurrence in head and neck malignant peripheral nerve sheath tumor MPNSTs"; they also stated that "prior studies on head and neck sarcomas have consistently shown grade, size, and margin status as prognostic indicators of recurrence and survival". Given the above, and that the authors aimed at assessing the prognostic factors in patients affected by head and neck sarcomas, we found it not scientifically sounded to include in the study patients with incomplete data.…”

Adjuvant radiation for positive margins in adult head and neck sarcomas is associated with improved survival: Analysis of the National Cancer Database

“…Given the paucity of head and neck sarcomas, many physicians lack the familiarity and experience to adequately diagnose and treat these diseases promptly and according to best practice guidelines . Furthermore, data to support the best treatment modalities for this heterogeneous class of tumors in common clinical scenarios are limited to single institution series …”