Soft-tissue sarcomas of the head and neck: a retrospective analysis of the Alberta experience 1974 to 1999.
BACKGROUND
Soft-tissue sarcomas (STS) of the head and neck constitute a heterogeneous group of rare malignant tumors occurring in an uncommon site. The most common subtypes of STS in the head and neck are malignant fibrous histiocytoma, dermatofibrosarcoma protuberans, and fibrosarcoma. Evidence based subtype-specific treatment decisions are often not possible.


METHODS
The medical records of 110 patients diagnosed with head and neck sarcomas were reviewed. All were treated at one of the two major Cancer Centers in Alberta, Canada, between 1974 and 1999. Potential prognostic factors including age, sex, tumor size, histology, grade, tumor location (superficial or deep), and use of adjuvant treatment were evaluated. Cox proportional hazards models were developed to study the impact of these covariates on survival.


RESULTS
The median duration of follow-up was 61.5 months. Five year overall, disease specific, and relapse free survival were 65.8%, 83.4%, and 74.2%, respectively. With use of a Cox proportional-hazards model, tumor stage and grade were important prognostic factors affecting survival.


CONCLUSIONS
Tumor size and grade were important prognostic factors affecting survival. Tumor location in relation to the superficial fascia (depth) was the best predictor of outcome. The overall and disease-free survival in this patient group was excellent. However, this likely caused by the high proportion of patients with low-grade tumors in our study.
Huber
Gerhard Frank
GF
Department of Surgery (Otolaryngology-Head and Neck Surgery), University of Calgary, Calgary, Alberta, Canada.
Matthews
T Wayne
TW
Dort
Joseph C
JC
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta / Q000453:epidemiology; D001707:Biopsy, Needle; D002423:Cause of Death; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012509:Sarcoma / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D017678:Sex Distribution; D016019:Survival Analysis