Malignant fibrous histiocytoma of the head and neck region.
BACKGROUND
Malignant fibrous histiocytoma (MFH) is 1 of the most common soft tissue sarcomas in the head and neck.


METHODS
We conducted a retrospective review of patients with MFH of the head and neck region at a large multidisciplinary cancer center between 1973 and 2005.


RESULTS
Ninety-five patients were included in the study. The median age at diagnosis was 53 years (range, 3-90 years); 69% of the patients were men. The parotid or neck was the most common subsite (35%), and 23% of the cases were associated with prior radiation exposure. Although there were no significant differences in the distribution of age, sex, year of presentation, tumor location, size, local extension, or treatment between patients with and without prior radiation exposure, those with radiation-associated tumors were more likely to have positive or unclear surgical margins (p = .037). With a median follow-up of 34 months, 32 (39%) of the 83 patients treated at M. D. Anderson Cancer Center with curative intent had a recurrence (isolated local recurrence in 18, isolated distant recurrence in 8, both local and distant recurrence in 5, and regional recurrence in 1). For patients treated at our institution with curative intent, 5-year overall, disease-free, and disease-specific survival rates were 55%, 44%, and 69%, respectively. Prior radiation exposure and positive margins were associated with worse survival.


CONCLUSIONS
MFH of the head and neck region is often aggressive and characterized by local and/or distant recurrence and poor survival. Radiation-associated tumors seem to have an especially poor prognosis. Based on a significant body of literature, multidisciplinary evaluation and treatment of such high-grade sarcomas is encouraged.
Clark
David W
DW
Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Moore
Brian A
BA
Patel
Shreyaskumar R
SR
Guadagnolo
B Ashleigh
BA
Roberts
Dianna B
DB
Sturgis
Erich M
EM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D051677:Histiocytoma, Malignant Fibrous / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D055815:Young Adult