PROGNOSTIC FACTORS IN HEAD AND NECK SOFT-TISSUE SARCOMAS - ANALYSIS OF 128 CASES

Soft tissue sarcomas make up a heterogenous group of rare malignant tu mors originating from mesodermal tissues. Although there have been sev eral improvements in diagnostic methods, staging, and treatment over t he past few years, the prognosis of head and neck sarcomas remains wor se than those sited at the trunk or extremities. The purpose of this r etrospective study was to report the survival results of 128 consecuti ve patients with soft tissue sarcomas of the head and neck treated fro m 1953 to 1985. Of the 93 patients submitted to surgical resection, th e procedure was considered radical in 67 patients. Of the operated gru op, 46 patients (49.5%) developed recurrence of disease. Thirty-two pa tients underwent further treatment (surgery, radiotherapy, or chemothe rapy), and 14 patients were salvaged, giving the ultimate result of 65 .6% disease control rate in the operated group. The univariate surviva l analysis showed no statistical difference (P > 0.05) according to ag e, race, sex, and site or histologic type of the tumor. Radicality of surgery was an important prognostic factor affecting survival (P = 0.0 014 for disease-free interval and P = 0.0183 for overall survival). Th e multivariate analysis showed that the radicality of surgery and tumo r histology were independent prognostic factors affecting recurrence. The same variables and age group were related to the risk of death. Ev ery effort must be made to make an early diagnosis and a radical surgi cal resection of these tumors must be tried (except for embryonal rhab domyosarcoma), because it offers the best chance for cure. (C) 1994 Wi ley-Liss, Inc.