Head and neck sarcomas: the UCLA experience.
OBJECTIVE
To profile the clinical presentation, subtype distribution, and treatment results of sarcomas of the head and neck at a single tertiary academic center over an 11-year period.


METHODS
A retrospective review was performed by examining the records and reviewing the pathology of 186 patients with head and neck sarcomas treated at UCLA Medical Center from 2000 to 2011.


RESULTS
The mean age of the study population was 49 ± 22 years. 58% of the patients were male and 42% were female. Median duration of follow-up for the entire group was 18.5 months. The most common presenting symptom was a mass lesion in 59.9% of patients. The nasal cavity/sinus was the most common presenting site seen in 22% of patients. Solitary fibrous tumor/hemangiopericytoma was the most common subtype. 15% of patients had evidence of prior radiation exposure. 26.3% of tumors were greater than 5 cm and 35.5% were high-grade. Margins were positive in 31.2% of patients. Lymph node metastasis was rare at 6.5%. Perineural invasion was identified in 6.5%. Among all subtypes, 5-year recurrence-free survival and overall survival were 50% and 49%, respectively. Multivariate analysis demonstrated that grade and margin status were predictors of recurrence-free survival while grade and age affected overall survival.


CONCLUSIONS
Head and neck sarcomas are a rare entity frequently presenting as a mass lesion. In our series, lesions tended to be high-grade with a significant portion of surgical specimens having positive margins. Grade and margin status were the most important predictors of survival.
Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; UCLA Head and Neck Cancer Program, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Bobby A
BA
Tajudeen
Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Jennifer
J
Fuller
Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Chi
C
Lai
Department of Medicine Statistics Core, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Tristan
T
Grogan
Department of Medicine Statistics Core, David Geffen School of Medicine at UCLA, Los Angeles, CA; Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, CA.
David
D
Elashoff
Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, CA; UCLA Head and Neck Cancer Program, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Elliot
E
Abemayor
Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, CA; UCLA Head and Neck Cancer Program, David Geffen School of Medicine at UCLA, Los Angeles, CA. Electronic address: mstjohn@mednet.ucla.edu.
Maie
M
St John
D002140:California / Q000453:epidemiology; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012509:Sarcoma / Q000453:epidemiology* / Q000473:pathology; D015996:Survival Rate / Q000639:trends