Soft tissue sarcomas of the head and neck: Outcome and prognostic factors

Background. Soft tissue sarcomas of the head and neck are uncommon malignant tumors. Up till now, their treatment has not been standardized. We retrospectively reviewed the records of adult patients with soft tissue sarcomas of the head and neck to identify prognostic factors affecting local control and survival. Methods. The records of 48 adult patients with soft tissue sarcoma of the head and neck region treated between 1987 and 1997 were reviewed. The data were analyzed for the impact of potential prognostic factors on local control, disease-free survival, and overall survival. Factors evaluated were age, sex, tumor grade, T-stage, bone invasion, site, surgical margin, treatment modality, and radiation dose. Results. The 5-year actuarial local control rate of the entire group was 40%. Tumor size was the only predictor for local control on multivariate analysis. Combined surgery and radiotherapy appeared to yield superior local control compared with surgery alone (46% vs 35%); however, the difference was not significant (P < 0.06). The 5-year actuarial overall and disease-free survivals were 48% and 34%, respectively. On multivariate analysis, tumor size was a significant factor for local control and for overall and disease-free survivals, while histological grade was a significant predictor only for disease-free survival. Conclusion. Tumor size was a significant predictor factor for local control and for overall and disease-free survivals. Histological grade was another significant predictor, affecting only disease-free survival. There was a trend for better local control with the-addition of postoperative radio-therapy, although the difference did not reach significance, because of probable selection bias among the patients who were indicated for radiotherapy.