Malignant peripheral nerve sheath tumors of the head and neck: Demographics, clinicopathologic features, management, and treatment outcomes

Armin Arshi; Bobby A Tajudeen; Maie St John

doi:10.1016/j.oraloncology.2015.08.012

Malignant peripheral nerve sheath tumors of the head and neck: Demographics, clinicopathologic features, management, and treatment outcomes

Oral Oncol. 2015 Dec;51(12):1088-94. doi: 10.1016/j.oraloncology.2015.08.012. Epub 2015 Oct 9.

Authors

Armin Arshi¹, Bobby A Tajudeen², Maie St John³

Affiliations

¹ Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
² Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Head and Neck Cancer Program, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
³ Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Head and Neck Cancer Program, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. Electronic address: mstjohn@mednet.ucla.edu.

PMID: 26442813
DOI: 10.1016/j.oraloncology.2015.08.012

Abstract

Objectives: To determine the epidemiology and prognostic indicators in patients with malignant peripheral nerve sheath tumors (MPNST) of the head and neck.

Materials and methods: The surveillance, epidemiology, and end results registry was reviewed for patients with head and neck MPNST from 1973 to 2011. Study variables included age, sex, race, tumor size, stage at presentation, and treatment modality.

Results: There were 374 cases of head and neck MPNST identified. Mean age at diagnosis was 50.7 y ears; 60.2% of patients were male and 82.6% were white. After diagnosis, 38.8% of patients underwent surgery and radiation therapy and 48.1% underwent surgery alone. Kaplan-Meier analysis demonstrated overall (OS) and disease-specific survival (DSS) of 51% and 67% at 5 years. Multivariate Cox regression analysis showed that age (p=0.030), stage (p=0.002), surgery (p=0.037), and size (p<0.001) were predictors of OS, while stage (p<0.001) and size (p<0.001) were predictors of DSS. For stage I/II cancers, surgery (p=0.011) and size (p=0.010) were predictors of OS, and size (p=0.001) predicted DSS. For stage III/IV cancers, both radiotherapy (p=0.024, p=0.009) and size (p=0.001, p=0.001) predicted OS and DSS. For tumors ⩽5 cm, stage (p=0.031) predicted DSS. For tumors >5 cm, male gender (p=0.005), stage (p=0.001), surgery (p=0.003), and radiotherapy (p=0.050) were determinants of OS, and male gender (p=0.022), stage (p<0.001), and radiotherapy (p=0.002) were determinants of DSS.

Conclusion: Surgical resection confers survival benefit in patients with early stage MPNST, while radiotherapy improves survival in cases with metastatic disease. Surgery and radiotherapy are prognostically important in patients with tumors >5 cm.

Keywords: Database; Head and neck cancer; MPNST; Malignant; Nerve; Oral cancer; Peripheral; SEER; Tumor.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Disease-Free Survival
Female
Head and Neck Neoplasms* / mortality
Head and Neck Neoplasms* / pathology
Head and Neck Neoplasms* / therapy
Humans
Infant
Infant, Newborn
Kaplan-Meier Estimate
Logistic Models
Male
Middle Aged
Neurilemmoma* / mortality
Neurilemmoma* / pathology
Neurilemmoma* / therapy
Risk Factors
SEER Program
Survival Rate
Treatment Outcome
Young Adult

Grants and funding

ULITR000124/PHS HHS/United States