Head and neck sarcomas: treatment outcomes in a tertiary referral center in Argentina

Springer Science and Business Media LLC - Tập 25 - Trang 509-518 - 2021
Alejandro Yanzon1, Natalia Lucia Gomez1, Pedro Picco1, Luis Boccalatte1, Federico Cayol2, Juan Larrañaga1, Marcelo Figari1
1Head and Neck Surgery Section, General Surgery Service, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
2Oncology Section, Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

Tóm tắt

To analyze the clinical findings, management, and results of oncological treatments and to identify prognostic factors in patients diagnosed with head and neck sarcoma. We performed a retrospective analysis including 48 adult patients with primary head and neck sarcomas, treated between 2006 and 2018 in a referral center of Argentina. The median follow-up time was 44 months (range: 4–146 months). Five-year overall survival was 68%. On univariate analysis, radiation-induced sarcomas (p=0.038) had worse survival. Five-year disease-free survival was 58% and local recurrence at 2 years was 22.7%. On multivariate analysis, positive/close resection margins (p=0.031), radiation-induced sarcomas (p=0.037), and mandibular and oral cavity location (p=0.002) were independent prognostic factors associated to local recurrence and shorter disease-free survival. Head and neck sarcomas are a rare entity. Surgery is feasible in more than 80% of patients, with an acceptable overall and disease-free survival. Radiation-induced sarcomas, location in the mandible and oral cavity, and close margins were significant prognostic factors in our population.

Tài liệu tham khảo

Barosa J, Ribeiro J, Afonso L et al (2014) Head and neck sarcoma: analysis of 29 cases. Eur Ann Otorhinolaryngol Head Neck Dis 131(2):83–86 Tajudeen BA, Fuller J, Lai C et al (2014) Head and neck sarcomas: the UCLA experience. Am J Otolaryngol 35(4):476–481 O’Neill JP, Bilsky MH, Kraus D (2013) Head and neck sarcomas. Neurosurg Clin N Am 24(1):67–78. https://doi.org/10.1016/j.nec.2012.08.010 Aljabab AS, Nason RW, Kazi R, Pathak KA (2011) Head and neck soft tissue sarcoma. Indian J Surg Oncol 2(4):286–290 Peng KA, Grogan T, Wang MB (2014) Head and neck sarcomas: analysis of the SEER database. Otolaryngol Head Neck Surg 151(4):627–633 Mattavelli D, Miceli R, Radaelli S et al (2013) Head and neck soft tissue sarcomas: prognostic factors and outcome in a series of patients treated at a single institution. Ann Oncol 24(8):2181–2189 Van Damme JP, Schmitz S, Machiels JP et al (2010) Prognostic factors and assessment of staging systems for head and neck soft tissue sarcomas in adults. Eur J Surg Oncol 36(7):684–690 Tudor-Green B, Gomez R, Brennan PA (2017) Current update on the diagnosis and management of head and neck soft tissue sarcomas. J Oral Pathol Med 46(9):674–679 de Bree R, van der Waal I, de Bree E, Leemans CR (2010) Management of adult soft tissue sarcomas of the head and neck. Oral Oncol 46(11):786–790 Institute NC, National Cancer Institute. AJCC cancer staging manual 8th edition. Definitions. 2020. https://doi.org/10.32388/b30ldk Thiagarajan A, Iyer NG (2019) Genomics of radiation sensitivity in squamous cell carcinomas. Pharmacogenomics 20(6):457–466 Yeang MS, Tay K, Ong WS et al (2013) Outcomes and prognostic factors of post-irradiation and de novo sarcomas of the head and neck: a histologically matched case-control study. Ann Surg Oncol 20(9):3066–3075. https://doi.org/10.1245/s10434-013-2979-5 Yoel J, González Aguilar O, Simkin DO, Barg S (1987) Sarcomas of the jaw. Semin Surg Oncol 3(4):215–227 Kowalski LP, San CI (1994) Prognostic factors in head and neck soft tissue sarcomas: analysis of 128 cases. J Surg Oncol 56(2):83–88 Köhler HF, Neves RI, Brechtbühl ER et al (2008) Cutaneous angiosarcoma of the head and neck: report of 23 cases from a single institution. Otolaryngol Head Neck Surg 139(4):519–524 Pradier R, González A, Adan R et al (1993) Sarcomas de partes blandas en adultos. Rev Argent Cir 64:26–36 Bentz BG, Singh B, Woodruff J et al (2004) Head and neck soft tissue sarcomas: a multivariate analysis of outcomes. Ann Surg Oncol 11(6):619–628 Mücke T, Mitchell DA, Tannapfel A et al (2010) Outcome in adult patients with head and neck sarcomas-a 10-year analysis. J Surg Oncol 102(2):170–174. https://doi.org/10.1002/jso.21595 Eeles RA, Fisher C, A’Hern RP et al (1993) Head and neck sarcomas: prognostic factors and implications for treatment. Br J Cancer 68(1):201–207 Tran LM, Mark R, Meier R et al (1992) Sarcomas of the head and neck. Prognostic factors and treatment strategies. Cancer 70(1):169–177 Farhood AI, Hajdu SI, Shiu MH, Strong EW (1990) Soft tissue sarcomas of the head and neck in adults. Am J Surg 160(4):365–369. https://doi.org/10.1016/s0002-9610(05)80544-6 Wanebo HJ, Koness RJ, MacFarlane JK, et al. Head and neck sarcoma: report of the Head and Neck Sarcoma Registry. Society of Head and Neck Surgeons Committee on Research. Head Neck. 1992;14(1):1-7. Weber RS, Benjamin RS, Peters LJ et al (1986) Soft tissue sarcomas of the head and neck in adolescents and adults. Am J Surg 152(4):386–392 Freedman AM, Reiman HM, Woods JE (1989) Soft-tissue sarcomas of the head and neck. Am J Surg 158(4):367–372 Lindford A, McIntyre B, Marsh R et al (2015) Outcomes of the treatment of head and neck sarcomas in a tertiary referral center. Front Surg 2:19 Sturgis EM, Potter BO (2003) Sarcomas of the head and neck region. Curr Opin Oncol 15(3):239–252 Potter BO, Sturgis EM (2003) Sarcomas of the head and neck. Surg Oncol Clin N Am 12(2):379–417 Tejani M, Galloway T, Lango M et al (2013) Head and neck sarcomas: a comprehensive cancer center experience. Cancers 5(4):890–900. https://doi.org/10.3390/cancers5030890 Cancer. 1992;70(1):169-177. Zagars GK, Ballo MT, Pisters PWT et al (2003) Surgical margins and reresection in the management of patients with soft tissue sarcoma using conservative surgery and radiation therapy. Cancer 97(10):2544–2553. https://doi.org/10.1002/cncr.11367 Linford G, Egan R, Coderre-Ball A et al (2020) Patient and physician perceptions of lung cancer care in a multidisciplinary clinic model. Curr Oncol 27(1):e9–e19 Sharma N, George NA, Singh R et al (2018) Management of head and neck soft tissue sarcoma: 11-year experience at a tertiary care centre in South India. Indian J Surg Oncol 9(2):187–191 Gladdy RA, Qin L-X, Moraco N et al (2010) Do radiation-associated soft tissue sarcomas have the same prognosis as sporadic soft tissue sarcomas? J Clin Oncol 28(12):2064–2069. https://doi.org/10.1200/jco.2009.25.1728 Rosko AJ, Birkeland AC, Chinn SB et al (2017) Survival and margin status in head and neck radiation-induced sarcomas and de novo sarcomas. Otolaryngol Head Neck Surg 157(2):252–259