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Multidisciplinary management of head and neck sarcomas
R James Colville1, Fraser Charlton, Charles G Kelly
1Department of Plastic and Reconstructive Surgery, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, United Kingdom. jcolville@cmki.org
Background:
Head and neck sarcomas are extremely rare. This article reviews the management and outcomes in a multidisciplinary clinic.
Methods:
The records of 41 male and 19 female patients (mean age, 50 years) were reviewed. Forty percent underwent surgical resection only, 35% underwent surgery and adjuvant therapy, and 25% underwent radiotherapy and/or chemotherapy without surgery. Seventy-one percent had complete histologic clearance.
Results:
The mean follow-up was 3 years and 10 months, with an overall 5-year survival rate of 60%. Completeness of surgical excision was highly significant in determining 5-year local control (p < .025), and the addition of adjuvant radiotherapy had a major effect on local control, but only if complete surgical clearance had been achieved (p < .025). As expected, patients with more aggressive tumors had a significantly poorer overall prognosis, and achieving local control led to an enhanced 5-year survival (p < .025).
Conclusion:
These tumors are best managed in multidisciplinary clinics, and the mainstay of treatment is wide local excision and planned postoperative adjuvant radiotherapy.