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Leiomyosarcoma of the head and neck: a population-based analysis
Journal article   Open access   Peer reviewed

Leiomyosarcoma of the head and neck: a population-based analysis

Robert W Eppsteiner, Barry R DeYoung, Mohammed M Milhem and Nitin A Pagedar
Archives of otolaryngology--head & neck surgery, Vol.137(9), pp.921-924
09/2011
DOI: 10.1001/archoto.2011.147
PMCID: PMC4345042
PMID: 21930982
url
https://doi.org/10.1001/archoto.2011.147View
Published (Version of record) Open Access

Abstract

To describe the characteristics of head and neck leiomyosarcoma and to identify factors associated with survival. Retrospective population-based study. The 17-registry Surveillance, Epidemiology, and End Results database was used to identify 578 patients with leiomyosarcoma of the head and neck. Surgery and primary and adjuvant radiotherapy. Patient demographics and tumor characteristics were examined. Treatment modalities were compared, and survival was assessed using the log-rank test. The mean age at diagnosis was 64 years. Most tumors were smaller than 5 cm in greatest dimension (87%) and high grade (44% were moderately differentiated and 39% were poorly differentiated). The primary tumor demonstrated deep extension in 39% of cases, and 2% had lymph node metastases. The most common primary site was the skin and soft tissue of the head and neck (83%). Surgical treatment was provided to 89% of patients, 14% received adjuvant radiotherapy, and 4% received radiotherapy alone. The median observed survival was 84.7 months. The 5-year disease-specific survival rate was 87.6% in patients with well-differentiated tumors, 85.7% in patients with moderately differentiated tumors, and 52.7% in patients with poorly differentiated tumors (P < .001). Survival was better for patients who received surgery alone (median survival, 100.1 months [n = 413]) than for those who received radiotherapy alone (median survival, 16 months [n = 16]) or adjuvant radiotherapy (median survival, 64.2 months [n = 80]) (P < .001). The latter group was more likely to have poorly differentiated, large, locally invasive tumors. Leiomyosarcoma typically presents in older patients; it is often poorly differentiated; and improved survival is associated with surgical treatment.
 Prognosis Age Factors Skin Neoplasms - radiotherapy Humans Middle Aged Otorhinolaryngologic Neoplasms - pathology Otorhinolaryngologic Neoplasms - radiotherapy Male Leiomyosarcoma - radiotherapy Soft Tissue Neoplasms - surgery Registries - statistics & numerical data Skin Neoplasms - mortality Leiomyosarcoma - surgery Lymphatic Metastasis - pathology Aged, 80 and over Female Retrospective Studies Otorhinolaryngologic Neoplasms - mortality Radiotherapy, Adjuvant Skin Neoplasms - surgery Skin Neoplasms - pathology Soft Tissue Neoplasms - mortality Leiomyosarcoma - pathology Neoplasm Invasiveness Kaplan-Meier Estimate Combined Modality Therapy Soft Tissue Neoplasms - radiotherapy Otorhinolaryngologic Neoplasms - surgery Soft Tissue Neoplasms - pathology Leiomyosarcoma - mortality Aged Neoplasm Staging Population Surveillance

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