title: Sarcomas of the head and neck. Prognostic factors and treatment strategies.
abstract: The authors reviewed 164 cases of head and neck sarcoma from adult patients seen at the University of California, Los Angeles (UCLA), between 1955 and 1988. The median follow-up was 70 months. Multivariate analysis demonstrated that tumor grade, size, and surgical margin status were the most important independent prognostic factors. Thirty-one percent (27 of 85) of patients with high-grade lesions were free of disease versus 81% (44 of 55) with low-grade lesions at last follow-up. Sixty-seven percent (50 of 76) of patients with lesions smaller than 5 cm were free of disease versus 38% (33 of 88) with lesions larger than 5 cm. In 16 patients, low-grade lesions, measuring less than 5 cm and with negative margins histologically, were controlled with surgery alone. For the 94 patients whose primary tumors were treated at UCLA, local control was achieved in 52% (26 of 50) of patients treated with surgery alone and 90% (20 of 22) with combined therapy (surgery and radiation therapy [RT] with or without chemotherapy). Seventy-five percent (6 of 8) of patients with positive surgical margins treated with postoperative RT achieved local control versus 26% (5 of 19) of patients receiving no additional treatment. In conclusion, surgery alone appears to be adequate treatment for small, low-grade tumors and negative surgical margins. Patients with incomplete resection or high-grade tumors should receive aggressive treatment--surgery and RT.
authors.affiliation: Department of Radiation Therapy, Veterans Administration Wadsworth Medical Center, Los Angeles, CA 90073.
authors.forename: L M
authors.initials: LM
authors.lastname: Tran
authors.forename: R
authors.initials: R
authors.lastname: Mark
authors.forename: R
authors.initials: R
authors.lastname: Meier
authors.forename: T C
authors.initials: TC
authors.lastname: Calcaterra
authors.forename: R G
authors.initials: RG
authors.lastname: Parker
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005354:Fibrosarcoma / Q000401:mortality / Q000473:pathology / Q000628:therapy; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006393:Hemangiopericytoma / Q000401:mortality / Q000473:pathology / Q000628:therapy; D006394:Hemangiosarcoma / Q000401:mortality / Q000473:pathology / Q000628:therapy; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D009362:Neoplasm Metastasis; D009442:Neurilemmoma / Q000401:mortality / Q000473:pathology / Q000628:therapy; D009455:Neurofibroma / Q000401:mortality / Q000473:pathology / Q000628:therapy; D012516:Osteosarcoma / Q000401:mortality / Q000473:pathology / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D012509:Sarcoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents