Sarcomas of the head and neck: a 10-year retrospective of 25 patients to evaluate treatment modalities, function and survival

Abstract

Sarcomas of the maxillofacial region are rare but aggressive. Traditional treatment for those in the long bones has comprised neoadjuvant chemotherapy followed by resection, with or without radiotherapy. This philosophy has often been extrapolated to the management of sarcomas of the head and neck. We have treated 25 cases during the last 10 years (August 1997-2007), present our results, and evaluate the treatments and survival. The group contains both hard and soft tissue sarcomas, including 17 cases of osteosarcoma of the jaw. The overall survival was 80%. Our results are broadly in line with most comparable published series. We report disease status, microscopic response to chemotherapy, and functional outcome, and compare and contrast osteosarcomas of the jaws and the long bones. We think that in patients with sarcomas of the head and neck, particularly of the jaws, early radical resection should be considered the primary treatment with the aim of local control. Radiotherapy and chemotherapy should be considered if there are inadequate resection margins or distant spread. The role of neoadjuvant chemotherapy is questionable; because of the rarity of the disease, multicentre randomised trials should be encouraged to evaluate it.