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) |
|---|---|
| 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 |
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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 journal › Article
}
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 -