Clinico-epidemiological and treatment factors impact on survival in Egyptian patients with head and neck sarcoma: a retrospective case-series analysis

Abstract Background Head and neck sarcomas are very rare accounting for about 1% of head and neck malignancies and 5% of sarcomas. Outcomes have historically been worse in this group compared to other sarcomas, due to anatomical constraints that make complete surgical removal difficult and increased...

Full description

Saved in:
Bibliographic Details
Main Authors: Mohamed Reda Kelany, Asmaa A. Abd Eltawab, Mohamed Naguib Mohamed, Mohamed Fathy Bayomy, Doaa Atef Mohamed Soliman
Format: Article
Language:English
Published: SpringerOpen 2024-11-01
Series:Journal of the Egyptian National Cancer Institute
Subjects:
Online Access:https://doi.org/10.1186/s43046-024-00242-2
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846147476002701312
author Mohamed Reda Kelany
Asmaa A. Abd Eltawab
Mohamed Naguib Mohamed
Mohamed Fathy Bayomy
Doaa Atef Mohamed Soliman
author_facet Mohamed Reda Kelany
Asmaa A. Abd Eltawab
Mohamed Naguib Mohamed
Mohamed Fathy Bayomy
Doaa Atef Mohamed Soliman
author_sort Mohamed Reda Kelany
collection DOAJ
description Abstract Background Head and neck sarcomas are very rare accounting for about 1% of head and neck malignancies and 5% of sarcomas. Outcomes have historically been worse in this group compared to other sarcomas, due to anatomical constraints that make complete surgical removal difficult and increased local relapse rate. Surgery remains the main intervention although the data suggest the role of chemotherapy and irradiation as treatment options. Methodology and Design. Data of patients diagnosed with head and neck sarcoma were retrospectively collected. Clinicopathologic characteristics and patients’ management were reviewed. Time to relapse (TTR) includes both time to local relapse (TTLR) and time to systemic relapse (TTSR). Overall survival (OS), TTLR and TTSR were calculated with Kaplan Mayer analysis using log rank test. Results Twenty-four patients were retrospectively identified. Mean age was 37.7 years (range 17–80) with female gender predominance (62.5%). Rhabdomyosarcoma and osteosarcoma were the most common types (16.7%). At presentation, 23 patients showed localized disease (95.8%), while one patient was metastatic to the bone. Surgery was the primary treatment in 83.3% patients with different surgical margin status (R0 in 6/20, R1 in 11/20 and R2 in 3/20 patients), while 4/24 patients were not operated. Radiotherapy was applied as adjuvant treatment in 9 patients, as definitive in 2 and as palliative in one patient. Chemotherapy was administered in neoadjuvant/ adjuvant settings in 8 patients. Median follow-up was 31 months. Mean TTR for all surgically resected population was 39.8 months. Locally relapsed patients were 35% with mean TTLR 43.2 months while 15% of patients developed systemic relapse with mean TTSR 55 months. Mean OS of all studied patients was 48 months. Conclusion Head and neck sarcomas are rare challenging malignancies due to anatomical constrain, with only 20% achieving R0 surgical resection and > 30% suffering of local relapse after complete surgical resection.
format Article
id doaj-art-1f80401b4a2d44cf8eb0a541a932bbac
institution Kabale University
issn 2589-0409
language English
publishDate 2024-11-01
publisher SpringerOpen
record_format Article
series Journal of the Egyptian National Cancer Institute
spelling doaj-art-1f80401b4a2d44cf8eb0a541a932bbac2024-12-01T12:40:12ZengSpringerOpenJournal of the Egyptian National Cancer Institute2589-04092024-11-013611610.1186/s43046-024-00242-2Clinico-epidemiological and treatment factors impact on survival in Egyptian patients with head and neck sarcoma: a retrospective case-series analysisMohamed Reda Kelany0Asmaa A. Abd Eltawab1Mohamed Naguib Mohamed2Mohamed Fathy Bayomy3Doaa Atef Mohamed Soliman4Clinical Oncology, Faculty of Medicine Ain Shams UniversityClinical Oncology, Faculty of Medicine, Assuit UniversityOtolaryngology-Head and Neck Surgery, Faculty of Medicine Ain Shams UniversityClinical Oncology, Faculty of Medicine, Zagazig UniversityClinical Oncology, Faculty of Medicine Ain Shams UniversityAbstract Background Head and neck sarcomas are very rare accounting for about 1% of head and neck malignancies and 5% of sarcomas. Outcomes have historically been worse in this group compared to other sarcomas, due to anatomical constraints that make complete surgical removal difficult and increased local relapse rate. Surgery remains the main intervention although the data suggest the role of chemotherapy and irradiation as treatment options. Methodology and Design. Data of patients diagnosed with head and neck sarcoma were retrospectively collected. Clinicopathologic characteristics and patients’ management were reviewed. Time to relapse (TTR) includes both time to local relapse (TTLR) and time to systemic relapse (TTSR). Overall survival (OS), TTLR and TTSR were calculated with Kaplan Mayer analysis using log rank test. Results Twenty-four patients were retrospectively identified. Mean age was 37.7 years (range 17–80) with female gender predominance (62.5%). Rhabdomyosarcoma and osteosarcoma were the most common types (16.7%). At presentation, 23 patients showed localized disease (95.8%), while one patient was metastatic to the bone. Surgery was the primary treatment in 83.3% patients with different surgical margin status (R0 in 6/20, R1 in 11/20 and R2 in 3/20 patients), while 4/24 patients were not operated. Radiotherapy was applied as adjuvant treatment in 9 patients, as definitive in 2 and as palliative in one patient. Chemotherapy was administered in neoadjuvant/ adjuvant settings in 8 patients. Median follow-up was 31 months. Mean TTR for all surgically resected population was 39.8 months. Locally relapsed patients were 35% with mean TTLR 43.2 months while 15% of patients developed systemic relapse with mean TTSR 55 months. Mean OS of all studied patients was 48 months. Conclusion Head and neck sarcomas are rare challenging malignancies due to anatomical constrain, with only 20% achieving R0 surgical resection and > 30% suffering of local relapse after complete surgical resection.https://doi.org/10.1186/s43046-024-00242-2Head and neck sarcomasOverall survivalTime to relapse
spellingShingle Mohamed Reda Kelany
Asmaa A. Abd Eltawab
Mohamed Naguib Mohamed
Mohamed Fathy Bayomy
Doaa Atef Mohamed Soliman
Clinico-epidemiological and treatment factors impact on survival in Egyptian patients with head and neck sarcoma: a retrospective case-series analysis
Journal of the Egyptian National Cancer Institute
Head and neck sarcomas
Overall survival
Time to relapse
title Clinico-epidemiological and treatment factors impact on survival in Egyptian patients with head and neck sarcoma: a retrospective case-series analysis
title_full Clinico-epidemiological and treatment factors impact on survival in Egyptian patients with head and neck sarcoma: a retrospective case-series analysis
title_fullStr Clinico-epidemiological and treatment factors impact on survival in Egyptian patients with head and neck sarcoma: a retrospective case-series analysis
title_full_unstemmed Clinico-epidemiological and treatment factors impact on survival in Egyptian patients with head and neck sarcoma: a retrospective case-series analysis
title_short Clinico-epidemiological and treatment factors impact on survival in Egyptian patients with head and neck sarcoma: a retrospective case-series analysis
title_sort clinico epidemiological and treatment factors impact on survival in egyptian patients with head and neck sarcoma a retrospective case series analysis
topic Head and neck sarcomas
Overall survival
Time to relapse
url https://doi.org/10.1186/s43046-024-00242-2
work_keys_str_mv AT mohamedredakelany clinicoepidemiologicalandtreatmentfactorsimpactonsurvivalinegyptianpatientswithheadandnecksarcomaaretrospectivecaseseriesanalysis
AT asmaaaabdeltawab clinicoepidemiologicalandtreatmentfactorsimpactonsurvivalinegyptianpatientswithheadandnecksarcomaaretrospectivecaseseriesanalysis
AT mohamednaguibmohamed clinicoepidemiologicalandtreatmentfactorsimpactonsurvivalinegyptianpatientswithheadandnecksarcomaaretrospectivecaseseriesanalysis
AT mohamedfathybayomy clinicoepidemiologicalandtreatmentfactorsimpactonsurvivalinegyptianpatientswithheadandnecksarcomaaretrospectivecaseseriesanalysis
AT doaaatefmohamedsoliman clinicoepidemiologicalandtreatmentfactorsimpactonsurvivalinegyptianpatientswithheadandnecksarcomaaretrospectivecaseseriesanalysis