Annals of Surgical Oncology

, Volume 11, Issue 6, pp 619–628 | Cite as

Head and Neck Soft Tissue Sarcomas: A Multivariate Analysis of Outcomes

  • Brandon G. Bentz
  • Bhuvanesh Singh
  • James Woodruff
  • Murray Brennan
  • Jatin P. Shah
  • Dennis KrausEmail author
Original Articles



Soft tissue sarcomas of the head and neck region represent a rare group of tumors of which a limited number of published individual- and institution-based experiences exist.


We performed an analysis of head and neck sarcoma patients identified from our institution between 1973 and 1999. Exclusion criteria included pediatric rhabdomyosarcomas, sarcomas of the neuromeningeal axis or non–head and neck primary disease sites, and bone sarcomas. All cases underwent pathologic re-review before statistical analysis.


After pathologic review, 111 head and neck sarcoma patients remained (mean age, 47 ± 20 years). The median duration of follow-up was 51 months; the actuarial 5-year relapse-free, disease-specific, and overall survivals were 55%, 52%, and 44%, respectively. Forty-six percent remained free of recurrence at the most recent follow-up, and the most common site of recurrence was local followed by distant sites. By multivariate analysis, size and grade significantly influenced relapse-free, disease-specific, and overall survivals, whereas margin status additionally influenced relapse-free survival. Subset analysis of the fibrosarcoma/malignant fibrous histiocytoma and desmoid/dermatofibrosarcoma protuberans histologies was undertaken.


Size >5 cm and high-grade histology are considered poor prognostic indicators. Patients with either of these characteristics should be considered for adjuvant trials.

Key Words

Head and neck Sarcoma Multivariate analysis Retrospective Single institution 


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  1. 1.
    Patel SG, Shaha AR, Shah JP. Soft tissue sarcomas of the head and neck: an update. Am J Otolaryngol 2001;22:2–18.Google Scholar
  2. 2.
    Hajdu S. Pathology of Soft Tissue Tumors Philadelphia: Lea & Febiger, 1979.Google Scholar
  3. 3.
    Fletcher CD, Gustafson P, Rydholm A, Willen H, Akerman M. Clinicopathologic re-evaluation of 100 malignant fibrous histiocytomas: prognostic relevance of subclassification. J Clin Oncol 2001;19:3045–50.PubMedGoogle Scholar
  4. 4.
    Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958;53:457–61.Google Scholar
  5. 5.
    Peto R, et al. Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. Analysis and examples. Br J Cancer 1977;35:1–39.PubMedGoogle Scholar
  6. 6.
    Cox D. Regression models and life tables. J R Stat Soc 1972;34:187–220.Google Scholar
  7. 7.
    Allen PW, Allen LJ. Perce the permissive pathologist: a cautionary tale of one who misdiagnosed a pseudosarcoma, killed the patient and was found out. Aust N Z J Surg 1994;64:273–4.Google Scholar
  8. 8.
    Flens MJ, et al. The contribution of immunocytochemistry in diagnostic cytology. Comparison and evaluation with immunohistology. Cancer 1990;65:2704–11.Google Scholar
  9. 9.
    Kraus DH, et al. Prognostic factors for recurrence and survival in head and neck soft tissue sarcomas. Cancer 1994;74:697–702.Google Scholar
  10. 10.
    Le QT, et al. Prognostic factors in adult soft-tissue sarcomas of the head and neck. Int J Radiat Oncol Biol Phys 1997;37:975–84.Google Scholar
  11. 11.
    Kowalski LP, San CI. Prognostic factors in head and neck soft tissue sarcomas: analysis of 128 cases. J Surg Oncol 1994;56:83–8.Google Scholar
  12. 12.
    Dijkstra MD, et al. Survival of adult patients with head and neck soft tissue sarcomas. Clin Otolaryngol 1996;21:66–71.Google Scholar
  13. 13.
    Dudhat S, et al. Prognostic factors in head and neck soft tissue sarcomas. Cancer 2000;89:868–72.Google Scholar
  14. 14.
    Tran LM, et al. Sarcomas of the head and neck. Prognostic factors and treatment strategies. Cancer 1992;70:169–77.Google Scholar
  15. 15.
    Stojadinovic A, et al. Dermatofibrosarcoma protuberans of the head and neck. Ann Surg Oncol 2000;7:696–704.Google Scholar
  16. 16.
    Lewis JJ, Benedetti F. Adjuvant therapy for soft tissue sarcomas. Surg Oncol Clin North Am 1997;6:847–62.Google Scholar
  17. 17.
    Stojadinovic A, et al. Primary adult soft tissue sarcoma: time-dependent influence of prognostic variables. J Clin Oncol 2002;20:4344–52.CrossRefPubMedGoogle Scholar
  18. 18.
    Pisters PW, et al. Analysis of prognostic factors in 1,041 patients with localized soft tissue sarcomas of the extremities. J Clin Oncol 1996;14:1679–89.PubMedGoogle Scholar
  19. 19.
    Pisters PW, et al. A prospective randomized trial of adjuvant brachytherapy in the management of low-grade soft tissue sarcomas of the extremity and superficial trunk. J Clin Oncol 1994;12:1150–5.Google Scholar
  20. 20.
    Weber RS, et al. Soft tissue sarcomas of the head and neck in adolescents and adults. Am J Surg 1986;152:386–92.Google Scholar
  21. 21.
    Greager JA, et al. Soft tissue sarcomas of the adult head and neck. Cancer 1985;56:820–4.Google Scholar
  22. 22.
    Farhood AI, et al. Soft tissue sarcomas of the head and neck in adults. Am J Surg 1990;160:365–9.Google Scholar
  23. 23.
    Wanebo HJ, et al. Head and neck sarcoma: report of the Head and Neck Sarcoma Registry. Society of Head and Neck Surgeons Committee on Research. Head Neck 1992;14:1–7.Google Scholar
  24. 24.
    Eeles RA, et al. Head and neck sarcomas: prognostic factors and implications for treatment. Br J Cancer 1993;68:201–7.Google Scholar
  25. 25.
    Le Vay J, et al. An assessment of prognostic factors in soft-tissue sarcoma of the head and neck. Arch Otolaryngol Head Neck Surg 1994;120:981–6.Google Scholar
  26. 26.
    Willers H, 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;33:585–93.Google Scholar

Copyright information

© The Society of Surgical Oncology, Inc. 2004

Authors and Affiliations

  • Brandon G. Bentz
    • 1
  • Bhuvanesh Singh
    • 2
  • James Woodruff
    • 3
  • Murray Brennan
    • 2
  • Jatin P. Shah
    • 2
  • Dennis Kraus
    • 2
    • 4
    Email author
  1. 1.Department of Surgery, Division of Otolaryngology-Head & Neck SurgeryUniversity of Utah School of Medicine and the Huntsman Cancer InstituteSalt Lake City
  2. 2.Department of SurgeryMemorial Sloan-Kettering Cancer Center
  3. 3.Department of PathologyMemorial Sloan-Kettering Cancer Center
  4. 4.Head & Neck ServiceDepartment of Surgery, Memorial Sloan-Kettering Cancer Center

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