Soft tissue sarcomas of the head and neck: a single-centre experience.

Objective:  The aim of this study was to report our experience with malignant and borderline soft tissue tumours (STS) of the head and neck region in the period 1977–2000. Design:  Retrospective case study including new evaluation of histological specimens. Setting:  Tertiary centre, single centre. Participants:  Review of patient's records and new evaluation of pathological specimens were made for 66 patients. After evaluation only 36 patients (26 men and 10 women) still met present criteria for a STS in head and neck in adults. Results:  The original histological diagnosis was changed in 27 (41%) of the 66 patients with a primary diagnosis of sarcoma. After review the most common histological diagnoses were leiomyosarcoma (5) and rhabdomyosarcoma (5). Overall 5-year survival rate was 60%. Overall 5-year disease-free survival rate was 44%. The study showed that both tumour grade and surgical margin had a statistically significant impact on survival. No relation was found between survival and tumour size or age. Conclusion:  The grave prognosis especially for high-grade tumours emphasizes the need for improved treatment strategies. Furthermore, conclusions from older studies concerning prognosis may be obsolete as approximately 40% of tumours previously diagnosed as sarcomas may be invalid by present day standards. Keypoints • Tumour grade and surgical margins are the most significant impact factors upon survival of patients with soft tissue sarcomas (STS) of the head and neck. • Based upon our re-review of histological specimens as much as 40% of tumours previously diagnosed in older studies as sarcomas of the head and neck may be faulty by present standards. Such studies may therefore be obsolete. • Improved treatment strategies on STS of the head and neck should focus on high-grade tumours.