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Survival in patients with synovial sarcoma of the head and neck: Association with tumor location, size, and extension
Author(s) -
Harb William J.,
Luna Mario A.,
Patel Shreyaskumar R.,
Ballo Matthew T.,
Roberts Dianna B.,
Sturgis Erich M.
Publication year - 2007
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20564
Subject(s) - medicine , radiation therapy , head and neck cancer , synovial sarcoma , sarcoma , surgery , chemotherapy , head and neck , soft tissue , pathology
Abstract Background. The medical literature on synovial sarcoma (SS) of the head and neck region is limited. Thus, we determined whether clinical characteristics and treatment were associated with recurrence and survival rates in patients with SS of the head and neck. Methods. We retrospectively identified patients with a pathologic diagnosis of SS of the head and neck at our institution (a large tertiary comprehensive cancer center) and compared recurrence and survival rates by clinical characteristics and treatment. Results. Forty patients with SS of the head and neck were identified from 1945 to 2004 (first case in 1968), representing <5% of all head and neck sarcomas seen at our institution during this time period. Twenty‐three patients (58%) had the monophasic histologic subtype, 15 (38%) biphasic, and 2 unspecified. Most patients were male (73%), with a median age of 29years. SS tumors were most commonly located in the neck (60%); thus, the most common symptoms were a neck mass and neck pain. No patients reported a history of radiation exposure. Higher disease‐specific and overall survival rates were associated with upper aerodigestive tract location, tumors of ≤5 cm, and tumors did not extend into bone. Patients treated with surgery and adjuvant radiotherapy had higher survival and lower recurrence rates than did those treated with surgery alone or a combination of surgery, radiotherapy, and chemotherapy. This difference was not significant, and the subgroups were small, with substantial confounding by adverse prognostic factors. Conclusions. SS of the head and neck is extremely rare, and our results should be viewed with caution given the relatively small group size and treatment over a 36‐year period. Survival rates were associated with tumor location, size, and extension. Treatment of SS of the head and neck should be directed toward complete surgical resection. Given the known sensitivity of SS to contemporary chemotherapy, a multimodality approach should be considered in the perioperative setting, especially in high risk patients. © 2007 Wiley Periodicals, Inc. Head Neck 2007