Prognostic Factors and Oncological Outcomes of 122 Head and Neck Soft Tissue Sarcoma Patients Treated at a Single Institution

Abstract

Head and neck soft tissue sarcomas (HNSTS) are rare tumors with various histological types displaying different clinical behavior. As a result, prognostic factors of this disease remain unclear. The aim of this study was to investigate the prognostic factors and oncological outcomes of HNSTS. This retrospective study included 122 patients with HNSTS who were treated at our institution between 1995 and 2012. Univariate and multivariate analyses using the Cox proportional hazards model were used to determine clinicopathologic characteristics associated with locoregional control (LRC), disease-specific survival (DSS), and overall survival (OS). Rhabdomyosarcoma was the most common tumor type (20 %), followed by dermatofibrosarcoma protuberance (13 %) and angiosarcoma (12 %). In a follow-up of 72 months, the 5-year LRC, DSS, and OS rates were 76, 77, and 75 %, respectively. Univariate analyses showed that age (> 60 years), tumor size (> 10 cm), nodal metastasis, and overall stage were significant prognostic factors for LRC, DSS, and OS (p < 0.05). Histological grade was also significantly associated with DSS (p = 0.012) and OS (p = 0.002). In multivariate analysis, tumor size and nodal metastasis were independent prognostic factors for LRC (p < 0.05), while age, histological grade, and nodal metastasis remained independent variables for both DSS and OS (p < 0.05). Our data support that surgical excision of HNSTS contributes to acceptable survival rates. Several factors at diagnosis may be independently associated with recurrence and survival outcomes, and identification of these factors may help in selecting at-risk patients.