Abstract 80P
Background
Head and neck soft tissue sarcomas are rare, accounting for about 1% of head and neck malignancies and 5% of sarcomas. These tumours may arise from the musculofascial or the visceral compartment. The most frequently histological subtypes undifferentiated pleomorphic sarcoma, fibrosarcoma, leiomyosarcoma and neurogenic sarcoma. Outcomes have historically been worse in this group, due to anatomic constraints leading to difficulty in completely excising tumours, with high rates of local recurrence.
Methods
A retrospective analysis of the head and neck STS managed in the department of Surgical Oncology DRBRAIRCH, AIIMS, New Delhi from 1995-2020 was performed from the database. We aim to analyse head and neck STS database and describe clinicopathological characteristics, treatment and outcomes.
Results
A total of 77 head and neck soft tissue sarcoma cases were operated from 1995-2020 out of which 49(63.6%) were male and 28(36.4%) were female. The mean age was 39 years. Majority (93.5%) patients presented with swelling with average duration of 7 weeks followed by pain (24.6%) with average duration of 2 weeks. 21(27.2%) were treatment naïve patients and 56(72.7%) patients had received treatment in the form of surgery, CT or RT before reporting to our centre. WLE was done in 67(87%) cases, R2 resection was done in 8(10.3%) cases and 1 patient turned out to be inoperable. Reconstruction was required in 44(57%) cases and in majority of cases local flaps (32) were used. The most frequent histological type was DFSP (27%) followed by neurogenic tumour (15%), leiomyosarcoma (8%) and rhabdomyosarcoma (8%). Margins was involved in 15(19.4%) patients. No lymph nodal metastasis was not detected in any cases. Adjuvant RT was given in 44(57%) cases and adjuvant CT in 18(23%) cases. Recurrence was detected in 23(29.8%) patients out of which 15(11.5%) were locoregional recurrence and 8(10.3%) were systemic recurrence.
Conclusions
Head and neck soft tissue sarcomas are rare tumours with multiple histological subtypes with distinct clinicopathological behaviour and literature on the management protocols is scarce. In our experience standard management should include wide excision with aim of clear margin and adjuvant chemotherapy and radiotherapy in high grade and close margin/positive margin.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The author.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.