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Laryngorhinootologie 2022; 101(09): 751-762
DOI: 10.1055/a-1774-9318
Facharztwissen HNO

Weichgewebesarkome im Kopf-Hals-Bereich: Aktuelle Therapie – Teil 1

Current Therapy Standards for Soft Tissue Sarcomas in the Head and Neck Area – Part 1
Andreas Dietz
1   Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Universität Leipzig, Leipzig
,
Bernd Lethaus
,
Markus Pirlich
,
Matthäus Stöhr
,
Veit Zebralla
,
Gunnar Wichmann
,
Rüdiger Zimmerer
,
Susanne Wiegand
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Dem/der HNO-/MKG-Chirurg*in kommt in der Diagnostik und Therapie bei fast allen Weichgewebesarkomen im Kopf-Hals-Bereich eine zentrale Rolle zu. Die Patient*innen sind unverzüglich spezialisierten Zentren zuzuführen; der Tumor darf nur durch eine zurückhaltende Biopsie gesichert werden. Bei feststehender Histologie und Tumorausdehnung sollte interdisziplinär ein Therapiekonzept erarbeitet und der/die Patient*in möglichst im Rahmen von Studien behandelt werden.

Abstract

The present work discusses soft tissue sarcoma in the head and neck area, due to the new published German S3-Guideline “adult soft tissue sarcoma”. The head and neck surgeon plays the central role in the diagnosis and treatment of the vast majority of cases. It is crucial to admit the patients immediately to specialized centers for diagnoses and specific treatment. Regarding correct diagnostic procedures, in contrast to squamous cell carcinoma, a larger accidental excisional biopsy within the tumor tissue is strongly prognostic negative. After confirmation of histology and tumor extension, it is mandatory to discuss the interdisciplinary treatment concept. If possible, introduction of the patient in ongoing clinical studies is key.

Kernaussagen

  • Dem/der HNO-/MKG-Chirurg*in kommt in der Diagnostik und Behandlung der überwiegenden Zahl der Weichgewebesarkome im Kopf-Hals-Bereich eine zentrale Rolle zu.

  • Es ist von entscheidender Bedeutung, dass diese Tumoren unverzüglich spezialisierten Zentren zugeführt werden und lediglich durch eine zurückhaltende Biopsie gesichert werden.

  • Anschließend sollte ein streng nach aktuellen Leitlinien ausgewogenes Therapiekonzept erarbeitet und in erfahrenen Händen umgesetzt werden.

Schlüsselwörter

Weichgewebesarkom - Sarkom - Kopf-Hals-Sarkom - Chondrosarkom - Ewing-Sarkom - Rhabdomyosarkom

Keywords

soft tissue sarcoma - sarcoma - head and neck sarcoma - chondrosarcoma - Ewingʼs sarcoma - rhabdomyosarcoma


Publication History

Article published online:
30 August 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Toro JR, ravis LB, Wu HJ. et al. Incidence patterns of soft tissue sarcomas, regardless of primary site, in the surveillance, epidemiology and end results program, 1978–2001: An analysis of 26,758 cases. Int J Cancer 2006; 119 (12) 2922-2930
    CrossrefPubMedSearch in Google Scholar
  • 2 Stiller CA, Trama A, Serraino D. et al. Descriptive epidemiology of sarcomas in Europe: report from the RARECARE project. Eur J Cancer 2013; 49 (03) 684-695
    CrossrefPubMedSearch in Google Scholar
  • 3 Yang JC, Rosenberg SA, Glatstein EJ. et al. In: DeVita VT, Hellman S, Rosenberg SA, eds. Cancer: Principles and Practice of Oncology. In: Sarcomas of soft tis- sues. 4th ed. Philadelphia: J.B. Lippincott; 1993: 1436-1488
    Search in Google Scholar
  • 4 Lahat G, Tuvin D, Wei C. et al. Perspectives for Staging and Prognosis in Soft Tissue Sarcoma. Ann Surg Oncol 2008; 15 (10) 2739-2748
    CrossrefPubMedSearch in Google Scholar
  • 5 Lahat G, Lazar A, Lev D. Sarcoma epidemiology and etiology: poten- tial environmental and genetic factors. Surg Clin North Am 2008; 88 (03) 451-481
    CrossrefPubMedSearch in Google Scholar
  • 6 Mendenhall WM, Mendenhall CM, Werning JW. et al. Adult head and neck soft tissue sarcomas. Head Neck 2005; 27 (10) 916-922
    CrossrefPubMedSearch in Google Scholar
  • 7 Colville RJ, Charlton F, Kelly CG. et al. Multidisciplinary management of head and neck sarcomas. Head Neck 2005; 27 (09) 814-824
    CrossrefPubMedSearch in Google Scholar
  • 8 AWMF-S3-Leitlinie "Adulte Weichgewebesarkome", Version 1.0, Register-Nr. 032/044OL (Stand 2021).
    PubMed
  • 9 Ressing M, Wardelmann E, Hohenberger P. et al. Strengthening health data on a rare and heterogeneous disease: sarcoma incidence and histological subtypes in Germany. BMC Public Health 2018; 18 (01) 235
    CrossrefPubMedSearch in Google Scholar
  • 10 Fletcher CDM, Unni KK, Mertens F. Pathology and Genetics of Tumours of Soft Tissue and Bone. WHO Classification of Tumours. Vol 5; 2002. ISBN-13: 9789283224136.
    PubMed
  • 11 Barnes L, Eveson JW, Reichart P. et al. Pathology and Genetics of Head and Neck Tumours, WHO Classification of Tumours. Vol 9; 2005. ISBN-13: 9789283224174.
    PubMed
  • 12 Koch BB, Karnell LH, Hoffman HT. et al. National cancer database report on chondrosarcoma of the head and neck. Head Neck 2000; 22 (04) 408-425
    CrossrefPubMedSearch in Google Scholar
  • 13 AWMF-Leitlinie der Deutschen Krebsgesellschaft und der Gesellschaft für Pädiatrische Onkologie und Hämatologie „Weichteilsarkome“ (Stand 2008).
    PubMed
  • 14 Kraus DH, Dubner S, Harrison LB. et al. Prognostic factors for recurrence and survival in head and neck soft tissue sarcomas. Cancer 1994; 74: 697-702
    CrossrefPubMedSearch in Google Scholar
  • 15 Mundt KA, Dell LD, Crawford L. et al. Quantitative estimated exposure to vinyl chloride and risk of angiosarcoma of the liver and hepatocellular cancer in the US industry-wide vinyl chloride cohort: mortality update through 2013. Occup Environ Med 2017; 74 (10) 709-716
    CrossrefPubMedSearch in Google Scholar
  • 16 Willers H, Hug EB, Spiro IJ. et al. Adult soft tissue sarcomas of the head and neck treated by radiation and surgery or radiation alone: patterns of failure and prognostic factors. Int J Radiat Oncol Biol Phys 1995; 33: 585-593
    CrossrefPubMedSearch in Google Scholar
  • 17 Dijkstra MD, Balm AJM, van Coevorden F. et al. Survival of adult patients with head and neck soft tissue sarcomas. Clin Otolaryngol 1996; 21: 66-71
    CrossrefPubMedSearch in Google Scholar
  • 18 Ward JR, Feigenberg SJ, Mendenhall NP. et al. Radiation therapy for angiosarcoma. Head Neck 2003; 25: 873-878
    CrossrefPubMedSearch in Google Scholar
  • 19 Wittekind C. TNM-Klassifikation maligner Tumoren. 8. Aufl. WILEY-VCH; 2017
    Search in Google Scholar
  • 20 American Joint Committee on Cancer (AJCC). Soft tissue sarcoma. In: Greene FL. AJCC cancer staging manual. 6th ed. New York: Springer; 2002: 193-200
    Search in Google Scholar
  • 21 Barker. et al. 2003
    PubMed
  • 22 Penel N, Mallet Y, Robin YM. et al. Prognostic factors for adult sarcomas of head and neck. Int J Oral Maxillofac Surg 2008; 37 (05) 428-432
    CrossrefPubMedSearch in Google Scholar
  • 23 Wittekindt C, Streubel K, Arnold G. et al. Recurrent pleomorphic adenoma of the parotid gland: analysis of 108 consecutive patients. Head Neck 2007; 29 (09) 822-828
    CrossrefPubMedSearch in Google Scholar
  • 24 Guntinas-Lichius O, Klussmann JP, Wittekindt C. et al. Parotidec- tomy for benign parotid disease at a university teaching hospital: outcome of 963 operations. Laryngoscope 2006; 116 (04) 534-540
    CrossrefPubMedSearch in Google Scholar
  • 25 Gross JL, Younes RN, Haddad FJ. et al. Soft-tissue sarcomas of the chest wall: prognostic factors. Chest 2005; 127 (03) 902-908
    CrossrefPubMedSearch in Google Scholar
  • 26 Enneking WF, Spanier SS, Goodman MA. A system for the surgical staging of musculoskeletal sarcoma. Clin Orthop Relat Res 1980; 153: 106-120
    CrossrefPubMedSearch in Google Scholar
  • 27 Dietz A, Frerich B. Current opinion in treatment of soft tissue sarcoma. Laryngorhinootologie 2009; 88 (05) 293-302
    Thieme ConnectPubMedSearch in Google Scholar
  • 28 Enneking WF. Musculoskeletal Tumor Surgery. New York: Churchill Livingstone; 1983
    Search in Google Scholar
  • 29 Brennan MF, Casper ES, Harrison LB. et al. The role of multimodality therapy in soft-tissue sarcoma. Ann Surg 1991; 214: 328-336
    CrossrefPubMedSearch in Google Scholar
  • 30 Liuzzi JF, Da Cunha M, Salas D. et al. Soft-tissue sarcomas in the head and neck: 25 years of experience. Ecancermedicalscience 2017; 11: 740
    CrossrefPubMedSearch in Google Scholar
  • 31 Park JT, Roh JL, Kim SO. et al. Prognostic factors and oncological outcomes of 122 head and neck soft tissue sarcoma patients treated at a single institution. Ann Surg Oncol 2015; 22 (01) 248-255
    CrossrefPubMedSearch in Google Scholar
  • 32 Perez MC, Padhya TA, Messina JL. et al. Cutaneous angiosarcoma: a single-institution experience. Ann Surg Oncol 2013; 20 (11) 3391-3397
    CrossrefPubMedSearch in Google Scholar
  • 33 Gonzalez-Gonzalez R, Bologna-Molina R, Molina-Frechero N. et al. Prognostic factors and treatment strategies for adult head and neck soft tissue sarcoma. Int J Oral Maxillofac Surg 2012; 41 (05) 569-575
    CrossrefPubMedSearch in Google Scholar
  • 34 Mucke T, Mitchell DA, Tannapfel A. et al. Outcome in adult patients with head and neck sarcomas – a 10-year analysis. J Surg Oncol 2010; 102 (02) 170-174
    CrossrefPubMedSearch in Google Scholar
  • 35 Bell RS, O’Sullivan B, Liu FF. et al. The surgical margin in softtissue sarcoma. J Bone Joint Surg Am 1989; 71: 370-375
    CrossrefPubMedSearch in Google Scholar
  • 36 Snyderman CH, Kassam AB. Endoscopic techniques for pathology of the anterior cranial fossa and ventral skull base. J Am Coll Surg 2006; 202: 563
    CrossrefPubMedSearch in Google Scholar
  • 37 Rischin D, Porceddu S, Peters L. et al. Promising results with chemoradiation in patients with sinonasal undifferenti- ated carcinoma. Head Neck 2004; 26: 435-441
    CrossrefPubMedSearch in Google Scholar
  • 38 Gülicher D, Aumann V, Hauptmann K. et al. Epitheloides Leio- myosarkom der Mundhöhle. Klin Padiatr 2005; 217: 291-296
    PubMedSearch in Google Scholar