Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Ann Oncol. 2013 Aug;24(8):2181-9. doi: 10.1093/annonc/mdt126. Epub 2013 Apr 5.
Head and neck soft tissue sarcomas (STS) represent a rare disease.
One hundred and sixty-seven patients underwent surgery at our institution with an eradicating intent between 1990 and 2010. Local recurrence (LR), distant metastasis (DM) and disease-specific mortality (DSM) incidence were studied along with clinicopathological prognostic factors.
Ten-year crude cumulative incidence (CCI) of LR, DM and DSM were 19%, 11% and 26%, respectively (median follow-up 66 months). Independent prognostic factors for DSM were tumor size (P < 0.001) and grade (P = 0.032), while surgical margins obtained a border-line significance (0.070); LR was affected by the tumor size (P = 0.001), while DM only by grade (P = 0.047). The median survival after LR and DM were 14 months and 7 months, respectively. Tumors sited in the paranasal sinus and supraclavicular region had the worst survival.
Head and neck represent a very critical anatomical site for STS. Achievement of local disease control appears to be crucial, since even LR could be a life-threatening event.
头颈部软组织肉瘤(STS)是一种罕见的疾病。
1990 年至 2010 年间,我们机构对 167 名患者进行了根治性手术。研究了局部复发(LR)、远处转移(DM)和疾病特异性死亡率(DSM)的发生率以及临床病理预后因素。
LR、DM 和 DSM 的 10 年粗累积发生率(CCI)分别为 19%、11%和 26%(中位随访 66 个月)。DSM 的独立预后因素是肿瘤大小(P<0.001)和分级(P=0.032),而手术切缘具有边缘显著性(P=0.070);LR 受肿瘤大小影响(P=0.001),而 DM 仅受分级影响(P=0.047)。LR 和 DM 后的中位生存时间分别为 14 个月和 7 个月。位于鼻窦和锁骨上区域的肿瘤的生存最差。
头颈部是 STS 的一个非常关键的解剖部位。实现局部疾病控制似乎至关重要,因为即使是 LR 也可能是危及生命的事件。