Golledge J, Fisher C, Rhys-Evans P H
Royal Marsden Hospital, London, England.
Cancer. 1995 Sep 15;76(6):1051-8. doi: 10.1002/1097-0142(19950915)76:6<1051::aid-cncr2820760620>3.0.co;2-4.
Liposarcoma of the head and neck region represents approximately 1% of head and neck sarcomas. Therefore, there are few data on the natural history, presentation, treatment, and prognosis of this neoplasm.
This study is a report of data from 76 patients with head and neck liposarcoma of whom 4 were treated at The Royal Marsden Hospital during the past 50 years.
The median age of patient presentation was the seventh decade (range, 6 months-86 years), and 65% of the patients were male. The commonest site of presentation was the neck (28%), followed by the larynx (20%) and pharynx (18%). Sixty-two percent of tumors were low grade (well differentiated and myxoid), and 38% were high grade (pleomorphic and round cell). The principal determinant of outcome was histologic grade. Five-year survival by life-table analysis was 67% overall and varied with tumor type as follows: well differentiated 100%, myxoid 73%, pleomorphic 42%, and round cell 0%. Site appears to have had some influence on prognosis. Oral liposarcoma had a poor prognosis with a 5-year survival of 50%, despite the low grade of all tumors; however, the 5-year survival for laryngeal (89%) and head (83%) liposarcoma was considerably better. Tumor size did not affect prognosis. The mainstay of treatment was surgical excision, used alone in 70% of the cases. Radiotherapy was used with other treatments in 25% of the cases. Prognosis was best for patients treated with surgery only (5-year survival, 83%), compared with those receiving surgery plus radiotherapy (5-year survival, 63%), chemotherapy (5-year survival, 33%), and radiotherapy alone (5-year survival, 0%).
Liposarcoma rarely involves the head and neck region. The prognosis for patients with this disease appears to be better than for those with liposarcoma arising elsewhere, particularly in the retroperitoneum. Prognosis is principally dependent on histologic grade. Complete surgical excision provides the most effective treatment.
头颈部脂肪肉瘤约占头颈部肉瘤的1%。因此，关于这种肿瘤的自然史、临床表现、治疗及预后的数据较少。
本研究报告了76例头颈部脂肪肉瘤患者的数据，其中4例在过去50年中于皇家马斯登医院接受治疗。
患者就诊时的中位年龄为七十岁（范围6个月至86岁），65%的患者为男性。最常见的发病部位是颈部（28%），其次是喉部（20%）和咽部（18%）。62%的肿瘤为低级别（高分化和黏液样），38%为高级别（多形性和圆形细胞）。预后的主要决定因素是组织学分级。通过生命表分析得出的总体五年生存率为67%，并因肿瘤类型而异，具体如下：高分化型100%，黏液样73%，多形性42%，圆形细胞型0%。发病部位似乎对预后有一定影响。口腔脂肪肉瘤预后较差，五年生存率为50%，尽管所有肿瘤级别均较低；然而，喉部（89%）和头部（83%）脂肪肉瘤的五年生存率则明显更高。肿瘤大小不影响预后。治疗的主要手段是手术切除，70%的病例单独使用手术治疗。25%的病例将放疗与其他治疗联合使用。仅接受手术治疗的患者预后最佳（五年生存率83%），相比之下，接受手术加放疗的患者五年生存率为63%，接受化疗的患者五年生存率为33%，仅接受放疗的患者五年生存率为0%。
脂肪肉瘤很少累及头颈部区域。这种疾病患者的预后似乎比其他部位尤其是腹膜后脂肪肉瘤患者的预后要好。预后主要取决于组织学分级。完整的手术切除提供了最有效的治疗方法。
