HEAD AND NECK LIPOSARCOMA

Background. Liposarcoma of the head and neck region represents approxi mately 1% of head and neck sarcomas. Therefore, there are few data on the natural history, presentation, treatment, and prognosis of this ne oplasm. Methods. This study is a report of data from 76 patients with head and neck liposarcoma of whom 4 were treated at The Royal Marsden Hospital during the past 50 years. Results. The median age of patient presentation was the seventh decade (range, 6 months-86 years), and 65 % of the patients were male. The commonest site of presentation was th e neck (28%), followed by the larynx (20%) and pharynx (18%). Sixty-tw o percent of tumors were low grade (well differentiated and myxoid), a nd 38% were high grade (pleomorphic and round cell). The principal det erminant of outcome was histologic grade. Five-year survival by life-t able analysis was 67% overall and varied with tumor type as follows: w ell differentiated 100%, myxoid 73%, pleomorphic 42%, and round cell 0 %. Site appears to have had some influence on prognosis. Oral liposarc oma had a poor prognosis with a 5-year survival of 50%, despite the lo w grade of all tumors; however, the 5-year survival for laryngeal (89% ) and head (83%) liposarcoma was considerably better. Tumor size did n ot affect prognosis. The mainstay of treatment was surgical excision, used alone in 70% of the cases. Radiotherapy was used with other treat ments in 25% of the cases, Prognosis was best for patients treated wit h surgery only (5-year survival, 83%), compared with those receiving s urgery plus radiotherapy (5-year survival, 63%), chemotherapy (5-year survival, 33%), and radiotherapy alone (5-year survival, 0%). Complete surgical excision provides the most effective treatment. Conclusions. Liposarcoma rarely involves the head and neck region. The prognosis f or patients with this disease appears to be better than for those with liposarcoma arising elsewhere, particularly in the retroperitoneum. P rognosis is principally dependent on histologic grade.