PROGNOSTIC FACTORS FOR RECURRENCE AND SURVIVAL IN HEAD AND NECK SOFT-TISSUE SARCOMAS

Background. Soft tissue sarcomas of the head and neck represent uncomm on malignant neoplasms. With the exception of orbital and parameningea l sites, the treatment of sarcomas in the head and neck has not been s tandardized. The authors used a prospectively collected database of ad ult soft tissue sarcomas to identify prognostic factors for local cont rol and survival. Methods. A prospectively collected database of adult soft tissue sarcoma from 1982 to 1989 was analyzed for the impact of prognostic factors on local control and survival. Factors examined inc luded histologic type, tumor grade, size, and resection margins. Resul ts. The overall and disease free survival at 5 years was 71 and 60%, r espectively. Local control was 70% at 5 years. On univariate analysis, grade and margin status were predictors for local control. Analysis b ased on the Cox proportional hazard model revealed that margin status was the only significant factor in predicting local control. Grade and margin status were significant prognostic indicators for survival bot h on univariate analysis and in the Cox proportional hazard model. Con clusion. Patients with head and neck sarcomas should undergo wide exci sion with the removal of all gross disease and the acquisition of nega tive, microscopic surgical margins. Patients with positive margins sho uld receive adjuvant radiotherapy for local control. High grade lesion s place patients at risk for local recurrence and distant disseminatio n. Investigational regimens designed to prevent metastatic disease sho uld be performed.