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Outcomes and prognostic factors of post-irradiation and de novo sarcomas of the head and neck: A histologically matched case-control study

Journal Article


Abstract


  • Background: This study was designed to compare post-irradiation sarcomas (PIS) and de novo sarcomas (DN) of the head and neck in terms of tumor characteristics, prognostic factors, and survival outcomes.

    Methods: All (N = 83) head and neck sarcoma patients treated at National Cancer Centre, Singapore (Feb 2002–May 2011) were included: DN (N = 60; 72 %); PIS (N = 23; 28 %). Clinicopathologic features and outcomes of all patients and histologically matched pairs were compared. Prognostic factors were identified using univariate and multivariate analyses.

    Results: Median age, gender, smoking status, and tumor size were not significantly different. Significant differences were seen in histology (most prevalent: PIS–sarcoma-NOS; DN–angiosarcoma) and tumor subsite (most prevalent: PIS–nasal cavity and sinuses; DN–skin). Median latency of PIS development was 16.7 years. PIS patients had shorter overall survival (OS) and disease-specific survival (DSS) compared with DN patients, most clearly seen on histologically matched pair analysis: 2-year OS (PIS: 54 %; DN: 83 %; P = 0.028). Multivariate analyses showed that age >50 years (hazard ratio (HR) = 3.68; P = 0.007), ever-smokers (HR = 2.79; P = 0.017), and larger tumor-size (cm) (HR = 1.12; P = 0.045) were associated with worse OS, and age at >50 years (HR = 2.77; P = 0.04) and ever-smokers (HR = 2.94; P = 0.021) were associated with worse DSS. When treated with curative intent, no significant survival difference was noted between DN and PIS patients.

    Conclusions: In our cohort, PIS constituted 28 % of head and neck sarcomas. Poorer prognosis traditionally associated with PIS compared with DN was not seen amongst patients treated with curative intent.

UOW Authors


  •   Yeang, Ming Sheng (external author)
  •   Tay, Kaijun (external author)
  •   Ong, Whee Sze (external author)
  •   Thiagarajan, Anuradha (external author)
  •   Tan, Daniel Shao Weng (external author)
  •   Ha, Tam
  •   Teo, Patrick Tze Hern (external author)
  •   Soo, Khee Chee (external author)
  •   Tan, Hiang Khoon (external author)
  •   Iyer, N. Gopalakrishna (external author)

Publication Date


  • 2013

Citation


  • Yeang, M., Tay, K., Ong, W., Thiagarajan, A., Tan, D., Ha, T. Cam., Teo, P., Soo, K., Tan, H. & Iyer, N. (2013). Outcomes and prognostic factors of post-irradiation and de novo sarcomas of the head and neck: A histologically matched case-control study. Annals of Surgical Oncology, 20 (9), 3066-3075.

Scopus Eid


  • 2-s2.0-84881479242

Has Global Citation Frequency


Number Of Pages


  • 9

Start Page


  • 3066

End Page


  • 3075

Volume


  • 20

Issue


  • 9

Place Of Publication


  • United States

Abstract


  • Background: This study was designed to compare post-irradiation sarcomas (PIS) and de novo sarcomas (DN) of the head and neck in terms of tumor characteristics, prognostic factors, and survival outcomes.

    Methods: All (N = 83) head and neck sarcoma patients treated at National Cancer Centre, Singapore (Feb 2002–May 2011) were included: DN (N = 60; 72 %); PIS (N = 23; 28 %). Clinicopathologic features and outcomes of all patients and histologically matched pairs were compared. Prognostic factors were identified using univariate and multivariate analyses.

    Results: Median age, gender, smoking status, and tumor size were not significantly different. Significant differences were seen in histology (most prevalent: PIS–sarcoma-NOS; DN–angiosarcoma) and tumor subsite (most prevalent: PIS–nasal cavity and sinuses; DN–skin). Median latency of PIS development was 16.7 years. PIS patients had shorter overall survival (OS) and disease-specific survival (DSS) compared with DN patients, most clearly seen on histologically matched pair analysis: 2-year OS (PIS: 54 %; DN: 83 %; P = 0.028). Multivariate analyses showed that age >50 years (hazard ratio (HR) = 3.68; P = 0.007), ever-smokers (HR = 2.79; P = 0.017), and larger tumor-size (cm) (HR = 1.12; P = 0.045) were associated with worse OS, and age at >50 years (HR = 2.77; P = 0.04) and ever-smokers (HR = 2.94; P = 0.021) were associated with worse DSS. When treated with curative intent, no significant survival difference was noted between DN and PIS patients.

    Conclusions: In our cohort, PIS constituted 28 % of head and neck sarcomas. Poorer prognosis traditionally associated with PIS compared with DN was not seen amongst patients treated with curative intent.

UOW Authors


  •   Yeang, Ming Sheng (external author)
  •   Tay, Kaijun (external author)
  •   Ong, Whee Sze (external author)
  •   Thiagarajan, Anuradha (external author)
  •   Tan, Daniel Shao Weng (external author)
  •   Ha, Tam
  •   Teo, Patrick Tze Hern (external author)
  •   Soo, Khee Chee (external author)
  •   Tan, Hiang Khoon (external author)
  •   Iyer, N. Gopalakrishna (external author)

Publication Date


  • 2013

Citation


  • Yeang, M., Tay, K., Ong, W., Thiagarajan, A., Tan, D., Ha, T. Cam., Teo, P., Soo, K., Tan, H. & Iyer, N. (2013). Outcomes and prognostic factors of post-irradiation and de novo sarcomas of the head and neck: A histologically matched case-control study. Annals of Surgical Oncology, 20 (9), 3066-3075.

Scopus Eid


  • 2-s2.0-84881479242

Has Global Citation Frequency


Number Of Pages


  • 9

Start Page


  • 3066

End Page


  • 3075

Volume


  • 20

Issue


  • 9

Place Of Publication


  • United States