title: Soft tissue sarcoma of the head & neck: nomogram validation and analysis of staging systems.
abstract: OBJECTIVE
  Soft tissue sarcomas of the head and neck (STSHN) comprise a rare group of malignancies. Our objective is to determine the utility of soft tissue sarcoma staging systems within the head and neck, and to validate an individualized soft tissue sarcoma nomogram within head and neck primary sites.
  
  
  METHODS
  Previously-untreated patients with STSHN diagnosed and treated between 1982 and 2012 were eligible (n = 319, median follow-up 46 months). Clinical variables were extracted from a prospectively-maintained database. The performance of AJCC/UICC and MSK staging systems and a soft tissue sarcoma-specific nomogram were assessed.
  
  
  RESULTS
  Four-year overall survival (OS), disease specific survival (DSS), and recurrence-free survival (RFS) were 72%, 76%, and 71%, respectively. AJCC/UICC and MSK staging systems accurately stratified outcomes (OS, DSS, and RFS; P < 0.001 for all comparisons). The nomogram stratified outcomes by quartile (P < 0.001), and predicted risk of death at 4, 8 and 12 years (P < 0.001). Concordance indices for overall survival for the AJCC/UICC system, MSK system, and the nomogram were 0.71, 0.70, and 0.78, respectively.
  
  
  CONCLUSIONS
  Oncologic outcomes among groups of patients with STSHN can be accurately predicted using both the AJCC/UICC and MSK staging systems. A soft tissue sarcoma-specific nomogram provides reliable, individualized prognostic information for patients with STSHN.
authors.affiliation: Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Shuman
authors.forename: Murray F
authors.initials: MF
authors.lastname: Brennan
authors.forename: Frank L
authors.initials: FL
authors.lastname: Palmer
authors.forename: Deborah
authors.initials: D
authors.lastname: Kuk
authors.forename: Nicole
authors.initials: N
authors.lastname: Moraco
authors.forename: Samuel
authors.initials: S
authors.lastname: Singer
authors.forename: Jatin P
authors.initials: JP
authors.lastname: Shah
authors.forename: Snehal G
authors.initials: SG
authors.lastname: Patel
mesh_terms: D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049451:Nomograms; D011379:Prognosis; D012509:Sarcoma / Q000401:mortality / Q000473:pathology*
keywords: head and neck cancer; nomograms; soft tissue sarcoma; staging