Sarcomas of the Head and Neck: A 13-Year Retrospective Experience of a UK Sarcoma Center

Abstract

Sarcomas are malignant tumors of mesenchymal origin. They are relatively uncommon neoplasms, accounting for 1% of all malignancies but they are very aggressive. The purpose of this study is to describe the experience of the London Sarcoma Service/Head and Neck of the University College London Hospital in the management of Head & Neck sarcomas from 1997 to 2010. We performed a retrospective analysis of 121 sarcoma cases, which have been managed within the setting of the Head and Neck MDT at UCLH during a period of 13 years. There were 68 male (56%) and 53 female (44%) patients with mean age of 39 years (range 7-86). Among these, 43 (35.5%) displayed hard tissue sarcomas (osteosarcomas and Ewing sarcomas), 7 (5.8%) had chondrosarcomas and the remaining 71 (58.7%) patients suffered from various soft tissue sarcomas including, spindle cell sarcomas, rhabdomyosarcomas, leiomyosarcomas, liposarcomas, myxofibrosarcomas and other rarer subtypes. Moreover among this series 14 patients displayed radiation-induced sarcomas. Treatment modalities involved neoadjuvant or adjuvant chemotherapy, radical or debulking surgery and radiotherapy. The majority of the patients were treated with neoadjuvant chemotherapy followed by surgery. The period of follow up varied from 3 months to more than 10 years. We report disease status, treatment modalities and outcomes and survival rates. We conclude that apart from the histopathological grade of the disease, early aggressive treatment and tumor-free resection margins following radical surgery are the predominant factors of long-term survival.