Huber Gerhard Frank, Matthews T Wayne, Dort Joseph C
Department of Surgery (Otolaryngology-Head and Neck Surgery), University of Calgary, Calgary, Alberta, Canada.
Laryngoscope. 2006 May;116(5):780-5. doi: 10.1097/01.MLG.0000206126.48315.85.
Soft-tissue sarcomas (STS) of the head and neck constitute a heterogeneous group of rare malignant tumors occurring in an uncommon site. The most common subtypes of STS in the head and neck are malignant fibrous histiocytoma, dermatofibrosarcoma protuberans, and fibrosarcoma. Evidence based subtype-specific treatment decisions are often not possible.
The medical records of 110 patients diagnosed with head and neck sarcomas were reviewed. All were treated at one of the two major Cancer Centers in Alberta, Canada, between 1974 and 1999. Potential prognostic factors including age, sex, tumor size, histology, grade, tumor location (superficial or deep), and use of adjuvant treatment were evaluated. Cox proportional hazards models were developed to study the impact of these covariates on survival.
The median duration of follow-up was 61.5 months. Five year overall, disease specific, and relapse free survival were 65.8%, 83.4%, and 74.2%, respectively. With use of a Cox proportional-hazards model, tumor stage and grade were important prognostic factors affecting survival.
Tumor size and grade were important prognostic factors affecting survival. Tumor location in relation to the superficial fascia (depth) was the best predictor of outcome. The overall and disease-free survival in this patient group was excellent. However, this likely caused by the high proportion of patients with low-grade tumors in our study.
头颈部软组织肉瘤（STS）是一组异质性罕见恶性肿瘤，发生于不常见的部位。头颈部STS最常见的亚型是恶性纤维组织细胞瘤、隆突性皮肤纤维肉瘤和纤维肉瘤。基于证据的亚型特异性治疗决策往往无法做出。
回顾了110例诊断为头颈部肉瘤患者的病历。所有患者均于1974年至1999年期间在加拿大艾伯塔省的两个主要癌症中心之一接受治疗。评估了包括年龄、性别、肿瘤大小、组织学、分级、肿瘤位置（浅表或深部）以及辅助治疗使用情况等潜在预后因素。建立Cox比例风险模型以研究这些协变量对生存的影响。
中位随访时间为61.5个月。5年总生存率、疾病特异性生存率和无复发生存率分别为65.8%、83.4%和74.2%。使用Cox比例风险模型，肿瘤分期和分级是影响生存的重要预后因素。
肿瘤大小和分级是影响生存的重要预后因素。肿瘤相对于浅筋膜的位置（深度）是预后的最佳预测指标。该患者组的总生存率和无病生存率良好。然而，这可能是由于我们研究中低级别肿瘤患者比例较高所致。
