Eppsteiner Robert W, DeYoung Barry R, Milhem Mohammed M, Pagedar Nitin A
Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, 52242, USA.
Arch Otolaryngol Head Neck Surg. 2011 Sep;137(9):921-4. doi: 10.1001/archoto.2011.147.
To describe the characteristics of head and neck leiomyosarcoma and to identify factors associated with survival.
Retrospective population-based study.
The 17-registry Surveillance, Epidemiology, and End Results database was used to identify 578 patients with leiomyosarcoma of the head and neck.
Surgery and primary and adjuvant radiotherapy.
Patient demographics and tumor characteristics were examined. Treatment modalities were compared, and survival was assessed using the log-rank test.
The mean age at diagnosis was 64 years. Most tumors were smaller than 5 cm in greatest dimension (87%) and high grade (44% were moderately differentiated and 39% were poorly differentiated). The primary tumor demonstrated deep extension in 39% of cases, and 2% had lymph node metastases. The most common primary site was the skin and soft tissue of the head and neck (83%). Surgical treatment was provided to 89% of patients, 14% received adjuvant radiotherapy, and 4% received radiotherapy alone. The median observed survival was 84.7 months. The 5-year disease-specific survival rate was 87.6% in patients with well-differentiated tumors, 85.7% in patients with moderately differentiated tumors, and 52.7% in patients with poorly differentiated tumors (P < .001). Survival was better for patients who received surgery alone (median survival, 100.1 months [n = 413]) than for those who received radiotherapy alone (median survival, 16 months [n = 16]) or adjuvant radiotherapy (median survival, 64.2 months [n = 80]) (P < .001). The latter group was more likely to have poorly differentiated, large, locally invasive tumors.
Leiomyosarcoma typically presents in older patients; it is often poorly differentiated; and improved survival is associated with surgical treatment.
描述头颈部平滑肌肉瘤的特征，并确定与生存相关的因素。
基于人群的回顾性研究。
使用17个登记处的监测、流行病学和最终结果数据库，确定578名头颈部平滑肌肉瘤患者。
手术以及原发和辅助放疗。
检查患者人口统计学和肿瘤特征。比较治疗方式，并使用对数秩检验评估生存情况。
诊断时的平均年龄为64岁。大多数肿瘤最大直径小于5 cm（87%），且分级较高（44%为中度分化，39%为低分化）。39%的病例中，原发肿瘤表现为深部浸润，2%有淋巴结转移。最常见的原发部位是头颈部皮肤和软组织（83%）。89%的患者接受了手术治疗，14%接受了辅助放疗，4%仅接受了放疗。观察到的中位生存期为84.7个月。高分化肿瘤患者的5年疾病特异性生存率为87.6%，中分化肿瘤患者为85.7%，低分化肿瘤患者为52.7%（P < 0.001）。单纯接受手术的患者生存情况更好（中位生存期，100.1个月[n = 413]），优于仅接受放疗的患者（中位生存期，16个月[n = 16]）或接受辅助放疗的患者（中位生存期，64.2个月[n = 80]）（P < 0.001）。后一组患者更可能患有低分化、体积大、局部浸润性肿瘤。
平滑肌肉瘤通常发生于老年患者；常为低分化；手术治疗可提高生存率。
