Multimodality treatment of head-and-neck soft-tissue sarcomas and short-term outcomes: Analysis from sarcoma medical oncology clinic

Abstract

Background: Head-and-neck soft-tissue sarcomas (HNSTS) are extremely rare and lack definite guidelines. Methods: We retrospectively analyzed consecutive adult patients with HNSTS who presented to our sarcoma medical oncology clinic from January 2016 to October 2017. Results: There were a total of 30 patients. Unresectable localized disease was seen in 13 (43%) patients, metastatic disease 10 (34%) patients, while resectable disease in 7 (23%) patients only. Among unresectable localized disease, 3 (25%) patients could be converted to resectable disease after neoadjuvant therapy. Median follow period was 11 months. Progression-free survival was 19 months in patients with resectable disease and 6 months in patients with the unresectable/metastatic disease. Median OS was not reached. Conclusion: Unresectable HNSTS has a poor outcome. Neoadjuvant therapy can be tried in selected cases for achieving respectability or for vital organ preservation until robust data are available. A multidisciplinary approach for local control is crucial in managing unresectable HNSTS.

Key words

Head-and-neck sarcoma - multimodality treatment - neoadjuvant therapy - soft-tissue sarcoma - unresectable

• References

• 1 Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin 2017;67:7-30.
• 2 Singer S, Tap WD, Crago AM, O'Sullivan B. Soft tissue sarcoma. In: DeVita VT Jr., Lawrence TS, Rosenberg SA. editors. DeVita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology. USA: Wolters Kluwer; 2015. p. 1254.
• 3 SEER. Soft Tissue Sarcomas, Cancer Statistic Review; 1975– 2010. Available from: http://www.seer.cancer.gov/csr/19752010/resultsmerged/sect34softtissuesarcomas.pdf. [Last cited on 2018 Jun 08].
• 4 O'Sullivan B, Griffin AM, Dickie CI, Sharpe MB, Chung PW, Catton CN, et al. Phase 2 study of preoperative image-guided intensity-modulated radiation therapy to reduce wound and combined modality morbidities in lower extremity soft tissue sarcoma. Cancer 2013;119:1878-84.
• 5 Mattavelli D, Miceli R, Radaelli S, Mattavelli F, Cantù G, Barisella M, et al. Head and neck soft tissue sarcomas: Prognostic factors and outcome in a series of patients treated at a single institution. Ann Oncol 2013;24:2181-9.
• 6 Mendenhall WM, Mendenhall CM, Werning JW, Riggs CE, Mendenhall NP. Adult head and neck soft tissue sarcomas. Head Neck 2005;27:916-22.
• 7 Tejani MA, Galloway TJ, Lango M, Ridge JA, von Mehren M. Head and neck sarcomas: A comprehensive cancer center experience. Cancers (Basel) 2013;5:890-900.
• 8 Sidappa KT, Krishnamurthy A. Adult softtissue sarcomas of the head and neck. Indian J Cancer 2011;48:284-8.
• 9 Liuzzi JF, Da Cunha M, Salas D, Siso S, Garriga E. Soft-tissue sarcomas in the head and neck: 25 years of experience. Ecancermedicalscience 2017;11:740.
• 10 Galy-Bernadoy C, Garrel R. Head and neck soft-tissue sarcoma in adults. Eur Ann Otorhinolaryngol Head Neck Dis 2016;133:37-42.
• 11 Barker JL Jr., Paulino AC, Feeney S, McCulloch T, Hoffman H. Locoregional treatment for adult soft tissue sarcomas of the head and neck: An institutional review. Cancer J 2003;9:49-57.
• 12 de Bree R, van der Valk P, Kuik DJ, van Diest PJ, Doornaert P, Buter J, et al. Prognostic factors in adult soft tissue sarcomas of the head and neck: A single-centre experience. Oral Oncol 2006;42:703-9.