Zohar Y, Wulikh M, Aminov H, Sadov R, Gal R, Schwartz A, Herskovitz P, Kots M, Klein B
ENT and Head and Neck Surgery Dept., Hasharon Hospital, Golda Medical Center, Petah Tikva.
Harefuah. 1996 Jun 2;130(11):740-4, 799.
We reviewed patients with primary soft tissue and bone sarcomas treated in our department. Malignant tumors arising in somatic, connective, soft tissues, especially those of the head and neck, are uncommon and few reports have been published. Between 1980 and 1995 15 patients with head and neck sarcoma were seen. The major sites involved included: paranasal sinuses and orbits (2 patients), neck (4) and 1 each in the forehead, temporal region, mandible, parapharyngeal space, tongue, hypopharynx, larynx, cervico-mediastinal region and nasal cavity. Follow-up ranged from 1-16 years. The youngest patient was a 12-year-old male. Rhabdomyosarcoma, one of the most common mesenchymal tumors found in the head and neck, especially in children, was excluded from our study because of its different clinical behavior and its chemosensitivity, unlike other sarcomas. Most of our patients were treated with wide-field resection; 12 received postoperative radiation, and 3 combined surgery and chemotherapy. Wide excision with negative margins is considered an important, positive, prognostic factor, as the extent and adequacy of excision largely determines survival and the incidence of local recurrence. All our patients underwent initial, wide, local excision of the lesion. Our observations strongly suggest that wide resection is the most effective means of therapy for sarcoma of the head and neck. Radical neck dissection was not only performed for manifest regional neck metastases, but was also used for completing the enlarged, wide-excisions of liposarcomas. The worst survival was in patients with osteosarcoma, angiosarcoma and fibrosarcoma, with an absolute 5-year survival of 60% (9/15).
我们回顾了在我科接受治疗的原发性软组织和骨肉瘤患者。发生于躯体、结缔组织、软组织的恶性肿瘤，尤其是头颈部的此类肿瘤并不常见，相关报道较少。1980年至1995年间，我们共诊治了15名头颈部肉瘤患者。主要受累部位包括：鼻窦和眼眶（2例）、颈部（4例），前额、颞部、下颌骨、咽旁间隙、舌、下咽、喉、颈纵隔区域及鼻腔各1例。随访时间为1至16年。最年轻的患者为一名12岁男性。横纹肌肉瘤是头颈部最常见的间叶性肿瘤之一，尤其在儿童中多见，但因其临床行为和化学敏感性与其他肉瘤不同，故被排除在本研究之外。我们的大多数患者接受了广泛切除治疗；12例接受了术后放疗，3例接受了手术联合化疗。切缘阴性的广泛切除被认为是一个重要的、积极的预后因素，因为切除的范围和充分程度在很大程度上决定了生存率和局部复发率。我们所有的患者均接受了病变的初次广泛局部切除。我们的观察结果强烈表明，广泛切除是治疗头颈部肉瘤最有效的方法。根治性颈清扫术不仅用于明显的区域颈部转移，还用于完成脂肪肉瘤扩大的广泛切除。骨肉瘤、血管肉瘤和纤维肉瘤患者的生存率最差，5年绝对生存率为60%（9/15）。
