Survival and Margin Status in Head and Neck Radiation-Induced Sarcomas and De Novo Sarcomas

Andrew J. Rosko, Andrew C. Birkeland, Steven B. Chinn, Andrew G. Shuman, Mark E. Prince, Rajiv M. Patel, Jonathan B. McHugh, Matthew E. Spector

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective: To describe histologic subtypes and oncologic outcomes among patients with radiation-induced and de novo sarcomas of the head and neck. Study Design: Retrospective case series with chart review. Setting: Tertiary academic center. Subject and Methods: In total, 166 adult patients with sarcoma of the head and neck treated from January 1, 1985, to January 1, 2010, were included. Tumors were characterized as radiation induced (15.1%) vs de novo sarcomas (84.9%). Clinical and tumor characteristics were compared. The primary outcomes were overall survival (OS) and disease-specific survival (DSS). Results: Radiation-induced sarcomas were more likely to be high grade (P =.006) and advanced stage (P =.03). Chondrosarcoma was more common in de novo tumors (P =.02) while leiomyosarcoma (P =.01), sarcoma not otherwise specified (P =.02), and undifferentiated pleomorphic sarcoma (P <.001) were more common in radiation-induced sarcomas. Radiation-induced sarcomas were associated with statistically significantly worse DSS (P =.019) and OS (P =.005) compared with de novo sarcomas, but when only high-grade soft tissue sarcomas were analyzed, neither DSS (P =.48) nor OS (P =.29) differed. Margin status was a significant predictor of survival as both R0 and R1 resections correlated with statistically better DSS and OS compared with R2 (P <.001) resections and patients treated with radiation therapy/chemoradiation therapy alone (P =.005). Conclusion: Radiation-induced sarcomas of the head and neck correlate with worse survival compared with de novo tumors; however, when controlling for tumor grade and resection status, there is no statistically significant difference in observed outcomes.

Original languageEnglish (US)
Pages (from-to)252-259
Number of pages8
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume157
Issue number2
DOIs
StatePublished - Aug 1 2017
Externally publishedYes

Fingerprint

Sarcoma
Neck
Head
Radiation
Survival
Neoplasms
Chondrosarcoma
Leiomyosarcoma
Radiotherapy
Retrospective Studies

Keywords

  • head and neck cancer
  • margin status
  • radiation
  • sarcoma

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

Survival and Margin Status in Head and Neck Radiation-Induced Sarcomas and De Novo Sarcomas. / Rosko, Andrew J.; Birkeland, Andrew C.; Chinn, Steven B.; Shuman, Andrew G.; Prince, Mark E.; Patel, Rajiv M.; McHugh, Jonathan B.; Spector, Matthew E.

In: Otolaryngology - Head and Neck Surgery (United States), Vol. 157, No. 2, 01.08.2017, p. 252-259.

Research output: Contribution to journalArticle

Rosko, Andrew J. ; Birkeland, Andrew C. ; Chinn, Steven B. ; Shuman, Andrew G. ; Prince, Mark E. ; Patel, Rajiv M. ; McHugh, Jonathan B. ; Spector, Matthew E. / Survival and Margin Status in Head and Neck Radiation-Induced Sarcomas and De Novo Sarcomas. In: Otolaryngology - Head and Neck Surgery (United States). 2017 ; Vol. 157, No. 2. pp. 252-259.
@article{559a1f2124c54e45a1890880ae080703,
title = "Survival and Margin Status in Head and Neck Radiation-Induced Sarcomas and De Novo Sarcomas",
abstract = "Objective: To describe histologic subtypes and oncologic outcomes among patients with radiation-induced and de novo sarcomas of the head and neck. Study Design: Retrospective case series with chart review. Setting: Tertiary academic center. Subject and Methods: In total, 166 adult patients with sarcoma of the head and neck treated from January 1, 1985, to January 1, 2010, were included. Tumors were characterized as radiation induced (15.1{\%}) vs de novo sarcomas (84.9{\%}). Clinical and tumor characteristics were compared. The primary outcomes were overall survival (OS) and disease-specific survival (DSS). Results: Radiation-induced sarcomas were more likely to be high grade (P =.006) and advanced stage (P =.03). Chondrosarcoma was more common in de novo tumors (P =.02) while leiomyosarcoma (P =.01), sarcoma not otherwise specified (P =.02), and undifferentiated pleomorphic sarcoma (P <.001) were more common in radiation-induced sarcomas. Radiation-induced sarcomas were associated with statistically significantly worse DSS (P =.019) and OS (P =.005) compared with de novo sarcomas, but when only high-grade soft tissue sarcomas were analyzed, neither DSS (P =.48) nor OS (P =.29) differed. Margin status was a significant predictor of survival as both R0 and R1 resections correlated with statistically better DSS and OS compared with R2 (P <.001) resections and patients treated with radiation therapy/chemoradiation therapy alone (P =.005). Conclusion: Radiation-induced sarcomas of the head and neck correlate with worse survival compared with de novo tumors; however, when controlling for tumor grade and resection status, there is no statistically significant difference in observed outcomes.",
keywords = "head and neck cancer, margin status, radiation, sarcoma",
author = "Rosko, {Andrew J.} and Birkeland, {Andrew C.} and Chinn, {Steven B.} and Shuman, {Andrew G.} and Prince, {Mark E.} and Patel, {Rajiv M.} and McHugh, {Jonathan B.} and Spector, {Matthew E.}",
year = "2017",
month = "8",
day = "1",
doi = "10.1177/0194599817700389",
language = "English (US)",
volume = "157",
pages = "252--259",
journal = "Otolaryngology - Head and Neck Surgery (United States)",
issn = "0194-5998",
publisher = "Mosby Inc.",
number = "2",

}

TY - JOUR

T1 - Survival and Margin Status in Head and Neck Radiation-Induced Sarcomas and De Novo Sarcomas

AU - Rosko, Andrew J.

AU - Birkeland, Andrew C.

AU - Chinn, Steven B.

AU - Shuman, Andrew G.

AU - Prince, Mark E.

AU - Patel, Rajiv M.

AU - McHugh, Jonathan B.

AU - Spector, Matthew E.

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Objective: To describe histologic subtypes and oncologic outcomes among patients with radiation-induced and de novo sarcomas of the head and neck. Study Design: Retrospective case series with chart review. Setting: Tertiary academic center. Subject and Methods: In total, 166 adult patients with sarcoma of the head and neck treated from January 1, 1985, to January 1, 2010, were included. Tumors were characterized as radiation induced (15.1%) vs de novo sarcomas (84.9%). Clinical and tumor characteristics were compared. The primary outcomes were overall survival (OS) and disease-specific survival (DSS). Results: Radiation-induced sarcomas were more likely to be high grade (P =.006) and advanced stage (P =.03). Chondrosarcoma was more common in de novo tumors (P =.02) while leiomyosarcoma (P =.01), sarcoma not otherwise specified (P =.02), and undifferentiated pleomorphic sarcoma (P <.001) were more common in radiation-induced sarcomas. Radiation-induced sarcomas were associated with statistically significantly worse DSS (P =.019) and OS (P =.005) compared with de novo sarcomas, but when only high-grade soft tissue sarcomas were analyzed, neither DSS (P =.48) nor OS (P =.29) differed. Margin status was a significant predictor of survival as both R0 and R1 resections correlated with statistically better DSS and OS compared with R2 (P <.001) resections and patients treated with radiation therapy/chemoradiation therapy alone (P =.005). Conclusion: Radiation-induced sarcomas of the head and neck correlate with worse survival compared with de novo tumors; however, when controlling for tumor grade and resection status, there is no statistically significant difference in observed outcomes.

AB - Objective: To describe histologic subtypes and oncologic outcomes among patients with radiation-induced and de novo sarcomas of the head and neck. Study Design: Retrospective case series with chart review. Setting: Tertiary academic center. Subject and Methods: In total, 166 adult patients with sarcoma of the head and neck treated from January 1, 1985, to January 1, 2010, were included. Tumors were characterized as radiation induced (15.1%) vs de novo sarcomas (84.9%). Clinical and tumor characteristics were compared. The primary outcomes were overall survival (OS) and disease-specific survival (DSS). Results: Radiation-induced sarcomas were more likely to be high grade (P =.006) and advanced stage (P =.03). Chondrosarcoma was more common in de novo tumors (P =.02) while leiomyosarcoma (P =.01), sarcoma not otherwise specified (P =.02), and undifferentiated pleomorphic sarcoma (P <.001) were more common in radiation-induced sarcomas. Radiation-induced sarcomas were associated with statistically significantly worse DSS (P =.019) and OS (P =.005) compared with de novo sarcomas, but when only high-grade soft tissue sarcomas were analyzed, neither DSS (P =.48) nor OS (P =.29) differed. Margin status was a significant predictor of survival as both R0 and R1 resections correlated with statistically better DSS and OS compared with R2 (P <.001) resections and patients treated with radiation therapy/chemoradiation therapy alone (P =.005). Conclusion: Radiation-induced sarcomas of the head and neck correlate with worse survival compared with de novo tumors; however, when controlling for tumor grade and resection status, there is no statistically significant difference in observed outcomes.

KW - head and neck cancer

KW - margin status

KW - radiation

KW - sarcoma

UR - http://www.scopus.com/inward/record.url?scp=85026734556&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85026734556&partnerID=8YFLogxK

U2 - 10.1177/0194599817700389

DO - 10.1177/0194599817700389

M3 - Article

C2 - 28397585

AN - SCOPUS:85026734556

VL - 157

SP - 252

EP - 259

JO - Otolaryngology - Head and Neck Surgery (United States)

JF - Otolaryngology - Head and Neck Surgery (United States)

SN - 0194-5998

IS - 2

ER -