Soft tissue head and neck sarcoma: experience of a tertiary referral centre over a 15-year period

2019 ◽  
Vol 133 (12) ◽  
pp. 1053-1058
Author(s):  
L Harrison ◽  
T McCulloch ◽  
N Beasley
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Head And Neck ◽  
Tumour Size ◽  
Case Series ◽  
Soft Tissue Sarcomas ◽  
Prognostic Indicators ◽  
Histological Subtypes ◽  
Referral Centre ◽  
Tertiary Referral Centre

AbstractBackgroundHead and neck soft tissue sarcoma is uncommon. It is both histologically and clinically heterogeneous, ranging from an indolent, locally destructive tumour, to a locally aggressive neoplasm with metastatic potential.MethodsA retrospective review was conducted of all adult head and neck soft tissue sarcomas, including cases of malignant soft tissue sarcoma and all intermediate type tumours, diagnosed between 1997 and 2012.ResultsSixty-eight cases were identified in this series from the sarcoma multidisciplinary team. Seventeen different histological subtypes of sarcoma were identified. Neither age, gender nor tumour size were significant prognostic indicators for survival in this series.ConclusionPrognosis is dependent on histological subtype, underscoring the importance of histological classification. Some histological subtypes occur only once or twice in a decade, even within a large regional referral centre. An accumulation of evidence from relatively small case series is key in the long-term development of treatment strategies.

scholarly journals Adult Head and Neck Soft Tissue Sarcomas: Treatment and Outcome

Sarcoma ◽  
2008 ◽  
Vol 2008 ◽  
pp. 1-5 ◽  
Author(s):  
Rabindra P. Singh ◽  
Robert J. Grimer ◽  
Nabina Bhujel ◽  
Simon R. Carter ◽  
Roger M. Tillman ◽  
...  
Keyword(s):  
Overall Survival ◽  
Soft Tissue ◽  
Local Recurrence ◽  
Head And Neck ◽  
Metastatic Disease ◽  
Tumour Size ◽  
Soft Tissue Sarcomas ◽  
Histological Subtypes ◽  
Median Size ◽  
Adult Head

We have retrospectively analysed the experience of a musculoskeletal oncological unit in the management of adult head and neck soft tissue sarcomas from 1990 to 2005. Thirty-six patients were seen, of whom 24 were treated at this unit, the remainder only receiving advice. The median age of the patients was 46 years. Most of the sarcomas were deep and of high or intermediate grade with a median size of 5.5 cm. Eleven different histological subtypes were identified. Wide excision was possible only in 21% of the cases. 42% of the patients developed local recurrence and 42% developed metastatic disease usually in the lungs. Overall survival was 49% at 5 years. Tumour size was the most important prognostic factor. Adult head and neck soft tissue sarcomas have a high mortality rate with a high risk of local recurrence and metastatic disease. The rarity of the disease would suggest that centralisation of care could lead to increased expertise and better outcomes.

scholarly journals Imaging Soft-tissue Sarcomas of the Head and Neck: A Tertiary Soft-tissue Sarcoma Unit Experience

2019 ◽  
Vol 39 (11) ◽  
pp. 6223-6230 ◽  
Author(s):  
ALAA ALSADIK JALY ◽  
KHIN THWAY ◽  
PHILIP TOUSKA ◽  
ANITA WALE ◽  
AISHA MIAH ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Head And Neck ◽  
Soft Tissue Sarcomas

scholarly journals One-year mortality in patients with bone and soft tissue sarcomas as an indicator of delay in presentation

2015 ◽  
Vol 97 (6) ◽  
pp. 425-433 ◽  
Author(s):  
R Nandra ◽  
N Hwang ◽  
GS Matharu ◽  
K Reddy ◽  
R Grimer
Keyword(s):  
Prognostic Factors ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Performance Indicator ◽  
Tumour Size ◽  
Soft Tissue Sarcomas ◽  
Mortality Data ◽  
Term Survival ◽  
Duration Of Symptoms ◽  
One Year

Introduction For many cancers, one-year mortality following diagnosis is a reflection of either advanced stage at diagnosis, multiple co-morbidities and/or complications of treatment. One-year mortality has not been reported for soft tissue or bone sarcomas. This study reports 1-year sarcoma mortality data over a 25-year period, investigates prognostic factors and considers whether a delay in presentation affects 1-year mortality. Methods A total of 4,945 newly diagnosed bone sarcoma and soft tissue sarcoma patients were identified from a prospectively maintained, single institution oncology database. Of these, 595 (12%) died within 1 year of diagnosis. Both patient factors and tumour characteristics available at diagnosis were analysed for effect. Results There was significant variation in one-year mortality between different histological subtypes. There has been no significant change in mortality rate during the last 25 years (mean: 11.7%, standard deviation: 2.8 percentage points). Soft tissue sarcoma patients who survived over one year reported a longer duration of symptoms preceding diagnosis than those who died (median: 26 vs 20 weeks, p<0.001). Prognostic factors identified in both bone and soft tissue sarcomas mirrored those for mid to long-term survival, with high tumour stage, large tumour size, metastases at diagnosis and increasing age having the greatest predictive effect. Conclusions One-year mortality in bone and soft tissue sarcoma patients is easy to measure, and could be a proxy for late presentation and therefore a potential performance indicator, similar to other cancers. It is possible to predict the risk of one-year mortality using factors available at diagnosis. Death within one year does not correlate with a long history but is associated with advanced disease at diagnosis.

scholarly journals Management and outcome of acral soft-tissue sarcomas

2018 ◽  
Vol 100-B (11) ◽  
pp. 1518-1523 ◽  
Author(s):  
B. J. F. Dean ◽  
H. Branford-White ◽  
H. Giele ◽  
P. Critchley ◽  
L. Cogswell ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Local Recurrence ◽  
Soft Tissue Sarcoma ◽  
Tumour Size ◽  
Epithelioid Sarcoma ◽  
Soft Tissue Sarcomas ◽  
Amputation Rate ◽  
Increased Risk ◽  
Significant Difference ◽  
Partial Amputation

Aims The aim of this study was to evaluate the surgical management and outcome of patients with an acral soft-tissue sarcoma of the hand or foot. Patients and Methods We identified 63 patients with an acral soft-tissue sarcoma who presented to our tertiary referral sarcoma service between 2000 and 2016. There were 35 men and 28 women with a mean age of 49 years (sd 21). Of the 63 sarcomas, 27 were in the hands and 36 in the feet. The commonest subtypes were epithelioid sarcoma in the hand (n = 8) and synovial sarcoma in the foot (n = 11). Results In 41 patients (65%), the tumour measured less than 5 cm in its largest dimension (median size 3 cm (2 to 6)); 27 patients (43%) were diagnosed after inadvertent excision prior to their referral to the specialist sarcoma unit. After biopsy and staging, primary surgical intervention at the sarcoma unit was excision and limb salvage in 43 (68%), partial (digit or ray) amputation in 14 (22%), and more proximal amputation in six (10%). At final follow up, local recurrence had been treated by one partial amputation and six amputations, resulting in a partial amputation rate of 24% and a proximal amputation rate of 19%. The five-year survival rate was 82%. Patients who underwent inadvertent excision showed no statistically significant difference in survival or local recurrence, but were more likely to undergo amputation (p = 0.008). Large tumour size (> 5 cm) was associated with lower survival (p = 0.04) and a higher risk of local recurrence (p = 0.009;). Conclusion Most acral soft-tissue sarcomas measure less than 5 cm at presentation, indicating that while size can be a useful prognostic factor, it should not be used as a diagnostic threshold for referral. Increased tumour size is associated with a higher rate of local recurrence and reduced survival. Sarcoma excision with limb preservation does not result in an increased risk of local recurrence. Cite this article: Bone Joint J 2018;100-B:1518–23.

scholarly journals Expression of IL4Rα and IL13Rα1 Are Associated With Poor Prognosis of Soft-tissue Sarcoma of the Extremities, Superficial Trunk, and Retroperitoneum 

2020 ◽  
Author(s):  
Kyoung Min Kim ◽  
Usama Khamis Hussein ◽  
See-Hyoung Park ◽  
Young Jae Moon ◽  
Zhongkai Zhang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Cancer Progression ◽  
Univariate Analysis ◽  
Soft Tissue Sarcomas ◽  
Prognostic Indicators ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Human Soft Tissue

Abstract BackgroundIL4Rα and IL13Rα1 are constituents of the type II IL4 receptor. Recently, IL4Rα and IL13Rα1 were reported to have roles in cancer progression and suggested as potential prognostic markers. However, studies on IL4Rα and IL13Rα1 in soft-tissue sarcomas have been limited. MethodsThis study investigated the expression of IL4Rα and IL13Rα1 in 89 soft-tissue sarcomas of the extremities, superficial trunk, and retroperitoneum. ResultsIn human soft-tissue sarcomas, immunohistochemical expression of IL4Rα was significantly associated with IL13Rα1 expression. Nuclear and cytoplasmic expression of IL4Rα and IL13Rα1 were significantly associated with shorter survival of soft-tissue sarcoma patients in univariate analysis. Multivariate analysis indicated that nuclear expression of IL4Rα and IL13Rα1 were independent indicators of shorter overall survival (IL4Rα; p = 0.002, IL13Rα1; p = 0.016) and relapse-free survival (IL4Rα; p = 0.022, IL13Rα1; p < 0.001) of soft-tissue sarcoma patients. Moreover, the co-expression pattern of nuclear IL4Rα and IL13Rα1 was an independent indicator of shorter survival of soft-tissue sarcoma patients (overall survival; overall p < 0.001, relapse-free survival; overall p < 0.001). ConclusionsThis study suggests IL4Rα and IL13Rα1 are associated with the progression of soft-tissue sarcoma, and the expression of IL4Rα and IL13Rα1 might be novel prognostic indicators of soft-tissue sarcoma patients.

scholarly journals A review of adult head and neck soft tissue sarcoma in a tertiary centre: malaysia experience

2017 ◽  
Vol 16 (1) ◽  
pp. 69-76 ◽  
Author(s):  
Salman Amiruddin ◽  
Mohd Razif Muhamad Yunus ◽  
Marina Mat Baki
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Head And Neck ◽  
Local Control ◽  
Adjuvant Radiotherapy ◽  
Soft Tissue Sarcomas ◽  
Optimal Treatment ◽  
High Morbidity ◽  
High Grade ◽  
Adult Head

Background: Head and neck tissue sarcoma are rare with potential high morbidity and mortality. The purpose of the present study was to present these cases and determine the optimal treatment for adult patients with head and neck soft tissue sarcomas.Methods: It is a retrospective study of adult head and neck soft tissue sarcoma conducted in the Department of Otorhinolaryngology at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) which is one of the national referral center within the period of 16 years from 1998 till 2014.Results: Fourteen cases were reviewed in which7 histopathological variations of soft tissue sarcomas were identified. Local control after surgery alone or combined with radiotherapy was obtained in 50 % of the patients which is influenced by histologic grade, tumor size, and surgical margins. Patients with high-grade tumors or positive margins have improved local control if adjuvant radiotherapy is used. Distant metastases occurred in 14.2 % of patients and the 5-year survival rate was 50 %.Conclusions: The optimal treatment for adult head and neck soft tissue sarcomas is surgery. Adjuvant radiotherapy improves outcomes for those with high-grade tumors or positive margins.Bangladesh Journal of Medical Science Vol.16(1) 2017 p.69-76

scholarly journals Bone and Soft‐Tissue Sarcoma Risk in Long‐Term Survivors of Hereditary Retinoblastoma Treated With Radiation

2019 ◽  
Vol 37 (35) ◽  
pp. 3436-3445 ◽  
Author(s):  
Ruth A. Kleinerman ◽  
Sara J. Schonfeld ◽  
Byron S. Sigel ◽  
Jeannette R. Wong-Siegel ◽  
Ethel S. Gilbert ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Head And Neck ◽  
Cumulative Incidence ◽  
Soft Tissue Sarcomas ◽  
Bone Sarcoma ◽  
The Body ◽  
Radiotherapy Field ◽  
Screening Protocol ◽  
Clinical Surveillance

PURPOSE Survivors of hereditary retinoblastoma have excellent survival but substantially increased risks of subsequent bone and soft-tissue sarcomas, particularly after radiotherapy. Comprehensive investigation of sarcoma risk patterns would inform clinical surveillance for survivors. PATIENTS AND METHODS In a cohort of 952 irradiated survivors of hereditary retinoblastoma who were originally diagnosed during 1914 to 2006, we quantified sarcoma risk with standardized incidence ratios (SIRs) and cumulative incidence analyses. We conducted analyses separately for bone and soft-tissue sarcomas occurring in the head and neck (in/near the radiotherapy field) versus body and extremities (out of field). RESULTS Of 105 bone and 124 soft-tissue sarcomas, more than one half occurred in the head and neck (bone, 53.3%; soft tissue, 51.6%), one quarter in the body and extremities (bone, 29.5%; soft tissue, 25.0%), and approximately one fifth in unknown/unspecified locations (bone, 17.1%; soft tissue, 23.4%). We noted substantially higher risks compared with the general population for head and neck versus body and extremity tumors for both bone (SIR, 2,213; 95% CI, 1,671 to 2,873 v SIR, 169; 95% CI, 115 to 239) and soft-tissue sarcomas (SIR, 542; 95% CI, 418 to 692 v SIR, 45.7; 95% CI, 31.1 to 64.9). Head and neck bone and soft-tissue sarcomas were diagnosed beginning in early childhood and continued well into adulthood, reaching a 60-year cumulative incidence of 6.8% (95% CI, 5.0% to 8.7%) and 9.3% (95% CI, 7.0% to 11.7%), respectively. In contrast, body and extremity bone sarcoma incidence flattened after adolescence (3.5%; 95% CI, 2.3% to 4.8%), whereas body and extremity soft-tissue sarcoma incidence was rare until age 30, when incidence rose steeply (60-year cumulative incidence, 6.6%; 95% CI, 4.1% to 9.2%), particularly for females (9.4%; 95% CI, 5.1% to 13.8%). CONCLUSION Strikingly elevated bone and soft-tissue sarcoma risks differ by age, location, and sex, highlighting important contributions of both radiotherapy and genetic susceptibility. These data provide guidance for the development of a risk-based screening protocol that focuses on the highest sarcoma risks by age, location, and sex.

scholarly journals Expression of IL4Rα and IL13Rα1 are associated with poor prognosis of soft-tissue sarcoma of the extremities, superficial trunk, and retroperitoneum

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Kyoung Min Kim ◽  
Usama Khamis Hussein ◽  
See-Hyoung Park ◽  
Young Jae Moon ◽  
Zhongkai Zhang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Univariate Analysis ◽  
Soft Tissue Sarcomas ◽  
Receiver Operating Curve ◽  
Prognostic Indicators ◽  
Immunohistochemical Expression ◽  
Relapse Free Survival ◽  
Free Survival

Abstract Background IL4Rα and IL13Rα1 are constituents of the type II IL4 receptor. Recently, IL4Rα and IL13Rα1 were reported to have roles in cancer progression and suggested as potential prognostic markers. However, studies on IL4Rα and IL13Rα1 in soft-tissue sarcomas have been limited. Methods This study investigated the immunohistochemical expression of IL4Rα and IL13Rα1 in 89 soft-tissue sarcomas of the extremities, superficial trunk, and retroperitoneum. Immunohistochemical staining for IL4Rα and IL13Rα1 were scored according to a combination of staining intensity and staining area in tissue microarray samples. Positivity for the immunohistochemical expression of IL4Rα and IL13Rα1 were determined using receiver operating curve analysis. Statistical analysis was performed using regression analysis and a chi-square test. Results In human soft-tissue sarcomas, immunohistochemical expression of IL4Rα was significantly associated with IL13Rα1 expression. Nuclear and cytoplasmic expression of IL4Rα and IL13Rα1 were significantly associated with shorter survival of soft-tissue sarcoma patients in univariate analysis. Multivariate analysis indicated that nuclear expression of IL4Rα and IL13Rα1 were independent indicators of shorter overall survival (IL4Rα; p = 0.002, IL13Rα1; p = 0.016) and relapse-free survival (IL4Rα; p = 0.022, IL13Rα1; p < 0.001) of soft-tissue sarcoma patients. Moreover, the co-expression pattern of nuclear IL4Rα and IL13Rα1 was an independent indicator of shorter survival of soft-tissue sarcoma patients (overall survival; overall p < 0.001, relapse-free survival; overall p < 0.001). Conclusions This study suggests IL4Rα and IL13Rα1 are associated with the progression of soft-tissue sarcoma, and the expression of IL4Rα and IL13Rα1 might be novel prognostic indicators of soft-tissue sarcoma patients.

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