Head and neck soft tissue sarcomas of adult: prognostic value of surgery in multimodal therapeutic approach

Abstract 

Adult head and neck soft tissue sarcomas (AHNSTS) are rare, and data concerning treatment results are spare. To assess clinico-pathological characteristics, management prognostic factors, and survival of AHNSTS, we reviewed our experience of 28 recent successive new cases.

Data were collected from a retrospective database (1997–2002). Aggressive fibromatosis, dermatofibrosarcoma, Kaposi sarcoma, chondrosarcoma and osteogenic sarcoma were excluded. Univariate analysis for prognostic factors was performed with χ² test with Yates correction.

The median age was 45.7 years (range: 18–86). The male/female ratio was 15/13. The most common subtypes was rhabdomyosarcoma (seven cases). Twenty-two patients presented with previous inadequate resection performed elsewhere before admission. The most common location was neck muscles (11 cases). Nineteen patients had surgery (complete resection in 13 cases). Associated treatments were neoadjuvant chemotherapy, adjuvant chemotherapy and postoperative radiotherapy in respectively, 4, 3 and 10 cases. The 2-year overall survival was 56%. Rhabdomyosarcomas (p=0.005) and inadequate resection (p=0.04) were associated with poor outcome.

Large resection of AHNSTS in a multimodality approach may afford the best chance of disease control.

Keywords:  Head and neck, Soft tissue sarcoma, Clear margins, Prognosis, Rhabdomyosarcoma, Surgery, Cancer