Survival of Patients With Non‐Rhabdomyosarcoma Soft Tissue Sarcomas of the Head and Neck

Abstract

Objective To evaluate factors associated with overall survival (OS) of patients with non‐rhabdomyosarcoma soft tissue sarcomas of the head and neck. Study Design Retrospective cohort study. Methods The National Cancer Database was queried for cases of non‐rhabdomyosarcoma soft tissue sarcomas of the head and neck between 2004 and 2014. Cases were categorized according to the World Health Organization classification of soft tissue tumors. A multivariable Cox proportional hazards model was used to evaluate associations with OS. Results A total of 4,555 patients (63.6% male, 36.4% female, mean age 59.6 years) met inclusion criteria. The majority of tumors were classified as miscellaneous (35.9%), followed by vascular (20.1%), smooth muscle (13.5%), fibroblastic/myofibroblastic (12.1%), peripheral nerve (8.5%), adipocytic (7.4%), and undifferentiated (2.5%) sarcomas. The mean follow‐up was 37.9 months, and overall mortality (MR) was 45.3%. The best prognosis was seen with fibroblastic/myofibroblastic sarcomas (MR = 20.6%, P < .001), whereas vascular sarcomas had the worst prognosis (MR = 67.6%, P < .001). Resection with clear margins had better OS than microscopically positive margins (hazard ratio [HR] = 1.43, P < .001) or grossly positive margins (HR = 2.97, P < .001). Radiation therapy was associated with better OS than no radiation (HR = 0.86, P = .001). Conclusion Non‐rhabdomyosarcoma soft tissue sarcomas of the head and neck are associated with significant mortality. OS differs based on histologic subcategorization. Resection of the primary tumor with clear margins demonstrates improved OS for all histologies, suggesting this modality remains the preferred primary treatment when feasible. Level of Evidence 3 Laryngoscope, 131:E500–E508, 2021

Adjuvant therapy for orbital non-rhabdomyosarcoma soft tissue sarcoma: comparison of long-term outcome between radiotherapy and chemotherapy

“…To further avoid bias, we conducted survival analysis in grade 2 cases separately, which also indicating higher rate of death from disease in chemotherapy cohort than in RT cohort. Our study confirms the efficacy of RT in head and neck NRSTS reported by Rastatter et al [22] . Tinkle et al's [24] research has also reported excellent disease control with the use of brachytherapy in pediatric and young adult NRSTS patients.…”

“…The "RT with or without pazopanib" arm was closed early due to poor accrual; however, the "chemotherapy" arm completed full accrual [21] . Better prognosis is associated with smaller, nonmetastatic tumors, lower and more differentiated grade, and certain histologic type [22] . And, the AJCC 8 th edition T classifications can accurately predict 5-year disease-specific survival of head and neck STSs, as reported previously [23] .…”

Pretreatment tumor sampling and prognostic factors in patients with soft-tissue sarcoma of the head and neck

“…In previous studies, the diagnosis has often changed by retrospective pathological re-evaluation of tumor histology [3,16,24,26]. In our study, pathology reports and data on immunohistochemical markers were carefully reviewed by an experienced pathologist.…”

Oral soft-tissue sarcomas diagnosed in an oral pathology service: a 16year experience

“…In general, they represent 2-15% of all sarcomas in adults, and less than 1% of all malignant neoplasms originating in the oral cavity are sarcomas. [13][14][15][16][17][18][19][20] According to the World Health Organization (WHO), there are over fifty subtypes of sarcomas 10,17 coming from all mesenchymal tissues including bone, cartilage, muscle, fibrous, vascular, fat, and neural. 16 The classification proposed by WHO in 2002 include neoplasms with the same cellular differentiation, which is determined mainly by morphologic and immunohistochemical features.…”

“…16 The classification proposed by WHO in 2002 include neoplasms with the same cellular differentiation, which is determined mainly by morphologic and immunohistochemical features. 10 In this study we focused only on IOSTS. Few studies in the literature have focused on oral sarcomas 21 since most authors include them in head and neck tumors, as a whole.…”