Treatment of primary soft tissue sarcoma of the head and neck

Soft tissue sarcomas of the head and neck account for less than 1% of all malignant neoplasms in this region. A significantly increased risk of treatment failure is associated with high histologic grade, leading to an aggressive treatment. The medical records of 17 patients with soft tissue sarcomas of the head and neck were reviewed. They were divided into two groups according to age: 13 adults and 4 children. The former underwent wide surgical excision with postoperative radiotherapy in some cases and possibly chemotherapy. The 2 and 5 years survivals were 54% and 46% respectively. The latter, with rhabdomyosarcoma, underwent multimodality treatment (chemotherapy, surgery, radiotherapy). The 2 years survival was 50%. The mainstay of treatment of soft tissue sarcomas of the head and neck in adults remains surgery. Patients with incomplete resection or high grade tumour should receive more aggressive treatment (surgery and postoperative radiotherapy). The use of systemic chemotherapy has showed no statistically significant improvement in local control or survival. However, for rhabdomyosarcoma in children, chemotherapy is an essential part of treatment.