Park Jin Taek, Roh Jong-Lyel, Kim Seon-Ok, Cho Kyung-Ja, Choi Seung-Ho, Nam Soon Yuhl, Kim Sang Yoon
Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Ann Surg Oncol. 2015 Jan;22(1):248-55. doi: 10.1245/s10434-014-3870-8. Epub 2014 Jul 8.
Head and neck soft tissue sarcomas (HNSTS) are rare tumors with various histological types displaying different clinical behavior. As a result, prognostic factors of this disease remain unclear. The aim of this study was to investigate the prognostic factors and oncological outcomes of HNSTS.
This retrospective study included 122 patients with HNSTS who were treated at our institution between 1995 and 2012. Univariate and multivariate analyses using the Cox proportional hazards model were used to determine clinicopathologic characteristics associated with locoregional control (LRC), disease-specific survival (DSS), and overall survival (OS).
Rhabdomyosarcoma was the most common tumor type (20 %), followed by dermatofibrosarcoma protuberance (13 %) and angiosarcoma (12 %). In a follow-up of 72 months, the 5-year LRC, DSS, and OS rates were 76, 77, and 75 %, respectively. Univariate analyses showed that age (>60 years), tumor size (>10 cm), nodal metastasis, and overall stage were significant prognostic factors for LRC, DSS, and OS (p < 0.05). Histological grade was also significantly associated with DSS (p = 0.012) and OS (p = 0.002). In multivariate analysis, tumor size and nodal metastasis were independent prognostic factors for LRC (p < 0.05), while age, histological grade, and nodal metastasis remained independent variables for both DSS and OS (p < 0.05).
Our data support that surgical excision of HNSTS contributes to acceptable survival rates. Several factors at diagnosis may be independently associated with recurrence and survival outcomes, and identification of these factors may help in selecting at-risk patients.
头颈部软组织肉瘤(HNSTS)是罕见肿瘤,有多种组织学类型,表现出不同的临床行为。因此,该疾病的预后因素仍不明确。本研究的目的是调查HNSTS的预后因素和肿瘤学结局。
这项回顾性研究纳入了1995年至2012年间在本机构接受治疗的122例HNSTS患者。使用Cox比例风险模型进行单因素和多因素分析,以确定与局部区域控制(LRC)、疾病特异性生存(DSS)和总生存(OS)相关的临床病理特征。
横纹肌肉瘤是最常见的肿瘤类型(20%),其次是隆突性皮肤纤维肉瘤(13%)和血管肉瘤(12%)。在72个月的随访中,5年LRC、DSS和OS率分别为76%、77%和75%。单因素分析显示,年龄(>60岁)、肿瘤大小(>10 cm)、淋巴结转移和总体分期是LRC、DSS和OS的显著预后因素(p<0.05)。组织学分级也与DSS(p=0.012)和OS(p=0.002)显著相关。多因素分析中,肿瘤大小和淋巴结转移是LRC的独立预后因素(p<0.05),而年龄、组织学分级和淋巴结转移仍是DSS和OS的独立变量(p<0.05)。
我们的数据支持HNSTS的手术切除有助于获得可接受的生存率。诊断时的几个因素可能与复发和生存结局独立相关,识别这些因素可能有助于选择高危患者。