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 language | English (US) |
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Pages (from-to) | 252-259 |
Number of pages | 8 |
Journal | Otolaryngology - Head and Neck Surgery (United States) |
Volume | 157 |
Issue number | 2 |
DOIs | |
State | Published - Aug 1 2017 |
Externally published | Yes |
Keywords
- head and neck cancer
- margin status
- radiation
- sarcoma
ASJC Scopus subject areas
- Surgery
- Otorhinolaryngology