Abstract
Introduction: Sarcomas are rare mesenchymal malignancies (<1% of all cancer types), with 5–15% occurring in the head and neck. Common types include osteosarcoma, chondrosarcoma, and rhabdomyosarcoma. They often recur and have poor survival rates. Treatment involves surgery, radiation, and/or chemotherapy, utilizing a multidisciplinary approach. This study aimed to overview sarcomas at our hospital and illustrated the interdisciplinary management of pharyngeal and laryngeal cases. Methods: This single-center study provides a comprehensive analysis of head and neck sarcomas (HNS) and examines interdisciplinary treatment approaches for pharyngeal and laryngeal sarcomas in patients treated at the Department of Head and Neck Surgery, Technical University of Munich, from 2007 to 2022. The study encompasses data on age, gender, histopathological diagnoses, treatment modalities, follow-up, and outcomes, with an emphasis on histopathological findings and collaborative therapeutic strategies. Results: Twenty-seven cases of HNS were identified (2007–2022). Among these, 11 were pharyngeal or laryngeal sarcomas. All pharyngeal sarcomas underwent primary resection with reconstruction based on tumor location and extent. In laryngeal sarcomas, 3 required laryngectomy, 1 had a hemilaryngectomy, and 1 patient opted for primary radiochemotherapy over laryngopharyngectomy. Adjuvant radiotherapy was given in 5 cases, and radiochemotherapy in 3. Diagnoses included a range of soft tissue and bone sarcomas, such as liposarcoma, synovial sarcoma, and osteosarcoma. During the study period, 4 patients survived, 5 patients were noted as deceased, and survival data for 2 patients remain unavailable. Patients exhibited an average survival of 7.6 (±10.4) years. The survival times within this limited patient population exhibit significant variation. Histologically, a wide spectrum of low and high-grade soft tissue and bone sarcomas were diagnosed including liposarcoma, synovial sarcoma, Ewing, osteosarcoma, or chondrosarcoma. Conclusion: HNS are rare and challenging to treat. Surgery is the primary treatment, with postoperative radiotherapy recommended for incomplete resections or high-risk subtypes. Advanced surgical techniques and reconstruction allow for radical resections while preserving function. Incorporating genetic insights and better sarcoma classification can further optimize treatments.
Plain Language Summary
Sarcomas are rare cancers that make up less than 1% of all cancers, with 5–15% occurring in the head and neck area. Common types include osteosarcomas, chondrosarcomas, rhabdomyosarcomas, undifferentiated pleomorphic sarcomas, and angiosarcomas. These cancers often come back after treatment and have low survival rates. Treatment usually involves surgery, radiation, and chemotherapy, customized for each patient. A team approach involving different specialists is important for successful treatment. This study looks at cases of head and neck sarcomas (HNS) treated at the Technical University of Munich from 2007 to 2022. It focuses on the treatment of sarcomas in the throat (pharynx) and voice box (larynx). The study includes data on patient age, gender, type of cancer, treatment methods, follow-up, and outcomes, with an emphasis on the type of sarcoma and the combination of treatments used. We identified 27 cases of HNS, with 11 affecting the throat or voice box. All throat sarcomas were treated with surgery, with reconstruction based on the tumor’s location and size. For voice box sarcomas, 3 patients had their voice box removed, 1 had part of it removed, and 1 chose radiation and chemotherapy instead of surgery. Additional radiation was given in 5 cases, and combined radiation and chemotherapy in 3. The diagnoses included various types of soft tissue and bone sarcomas like liposarcoma, synovial sarcoma, and osteosarcoma. Taken together head and neck sarcomas are rare and difficult to treat. Surgery is the main treatment, with additional radiation recommended for incomplete surgeries or higher risk cancers. Advanced surgical methods help remove tumors while preserving function. Using genetic information and better classification of sarcomas could improve future treatments.
