title: Head and neck soft tissue sarcomas: unique lack of significance of synchronous node metastases.
abstract: BACKGROUND
  Regional lymph node metastasis (RLNM) has been identified as a poor prognostic indicator for patients with soft tissue sarcomas (STS) of the extremities and trunk. However, the effect of RLNM on survival in patients with STS of the head and neck (HN) has not previously been explored. Our objective was to analyze RLNM as a prognostic indicator in HN-STS, and to compare this cohort to patients with STS of non-head and neck regions (NHN-STS).
  
  
  METHODS
  STS patients were identified using the Surveillance, Epidemiology, and End Results database. Only patients without concurrent distant metastasis who underwent surgery and pathologic node staging were included. Patients were categorized based on tumor location: (1) HN-STS and (2) NHN-STS. Clinicopathologic data and disease-specific survival (DSS) were compared between node-negative and node-positive patients in each group.
  
  
  RESULTS
  We identified 183 cases of node-positive STS (25 HN-STS, 158 NHN-STS). In the HN-STS group, pN1 status was not associated with any of the clinicopathologic factors that we analyzed. DSS was similar among pN0 and pN1 patients with HN-STS (P = 0.59); however, in the NHN-STS group, node-positivity was significantly associated with disease-specific mortality (P < 0.001).
  
  
  CONCLUSIONS
  Synchronous RLNM may not affect DSS in patients HN-STS. Node-positive patients with HN-STS appear to be unique from those with NHN-STS.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, and Hollings Cancer Center, Medical University of South Carolina, Charleston, USA. elentsch@musc.edu
authors.forename: Valerie A
authors.initials: VA
authors.lastname: Smith
authors.forename: Lewis J
authors.initials: LJ
authors.lastname: Overton
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Lentsch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D006801:Humans; D007223:Infant; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018426:SEER Program; D012509:Sarcoma / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D015996:Survival Rate; D014481:United States; D055815:Young Adult