Multidisciplinary management of head and neck sarcomas

Background. Head and neck sarcomas are extremely rare. This article reviews the management and outcomes in a multidisciplinary clinic. Methods. The records of 41 male and 19 female patients (mean age, 50 years) were reviewed. Forty percent underwent surgical resection only, 35% underwent surgery and adjuvant therapy, and 25% underwent radiotherapy and/or chemotherapy without surgery. Seventy‐one percent had complete histologic clearance. Results. The mean follow‐up was 3 years and 10 months, with an overall 5‐year survival rate of 60%. Completeness of surgical excision was highly significant in determining 5‐year local control ( p < .025), and the addition of adjuvant radiotherapy had a major effect on local control, but only if complete surgical clearance had been achieved ( p < .025). As expected, patients with more aggressive tumors had a significantly poorer overall prognosis, and achieving local control led to an enhanced 5‐year survival ( p < .025). Conclusion. These tumors are best managed in multidisciplinary clinics, and the mainstay of treatment is wide local excision and planned postoperative adjuvant radiotherapy. © 2005 Wiley Periodicals, Inc. Head Neck 27: XXX–XXX, 2005