CHONDROSARCOMA OF THE HEAD AND NECK - THE UCLA EXPERIENCE, 1955-1988

Chondrosarcoma of the head and neck is a rare tumor. In an attempt to clarify optimal treatment of these lesions, we reviewed the records an d pathologic material of 18 consecutive cases of head and neck chondro sarcoma seen at our institution between 1955 and 1988. Follow-up range d from 3 to 168 months with a median of 72. Absolute 5-year survival w as 68% (11/16), with 9/16 (56%) patients surviving disease-free. Grade was the most important prognostic factor. Only one of 7 (14%) patient s known to have high grade histology was rendered disease-free, as opp osed to 9/10 (90%) with low-grade lesions. Tumor size and completeness of surgical resection were also important prognostic factors. Four of 10 patients managed initially with surgery alone achieved local contr ol with greater than 5-year survival. All four had low-grade lesions. Five patients received surgery and radiation as primary treatment, and three are disease-free with greater than 5-year follow-up. Two of the se were irradiated because of positive margins. One patient received r adiation alone and has persistent disease. Two patients received combi ned chemotherapy and surgery because of high-grade lesions, and one is free of disease with greater than 5-year follow-up. Patients with inc omplete resections should receive further surgery or postoperative rad iation therapy. High-grade lesions should be treated aggressively.