Prognostic factors for adult sarcomas of head and neck.
The optimal management of adult soft-tissue sarcomas is not clearly established. To assess prognostic factors and survival, the experience of 45 recent successive cases was reviewed. Data were collected from a retrospective database (1993-2005) and statistically analyzed. Rhabdomyosarcomas were excluded. The mean age was 50.1 years; there were 24 men and 21 women. The main histological subtypes were undifferentiated sarcoma (14) and angiosarcoma (10); 21 tumours were grade 3 (46%). The most frequent primary sites were neck muscles (15, 33%) and scalp (11, 24%). At presentation, 5 (20%) cases with lymph-node involvement and another 11 cases (24%) with distant metastasis were observed. The treatment was with curative intent in 33 cases (73%). This entailed surgery, with adjuvant radiotherapy in 15 cases and adjuvant chemotherapy in 5 cases. The 5-year overall survival was 52% (+/-8%). In univariate analysis, the poor prognostic factors were high grade, initial metastasis or lymph nodes, absence of surgery, and number of surgical procedures. In multivariate analysis, two factors remained significant: grade (P=0.006) and absence of surgery (P=0.005). After taking into account grade and metastasis at presentation, quality of surgery has prognostic value. The primary aim of a multidisciplinary approach to these tumours must favour complete resection.
Penel
N
N
Département de Cancérologie Générale, Centre Oscar Lambret, Lille, France. n-penel@o-lambret.fr
Mallet
Y
Y
Robin
Y-M
YM
Fournier
C
C
Grosjean
J
J
Ceugnart
L
L
Clisant
S
S
Lefebvre
J-L
JL
D000704:Analysis of Variance; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000534:rehabilitation / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012509:Sarcoma / Q000188:drug therapy / Q000473:pathology / Q000534:rehabilitation / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000534:rehabilitation / Q000601:surgery; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data