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 journalArticlepeer-review

11 Scopus citations


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)
Issue number2
StatePublished - Aug 1 2017
Externally publishedYes


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

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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