Abstract：
OBJECTIVE: Globally, head & neck sarcoma care pathways remain unclear. In 2018, the London Sarcoma Service (LSS) set up a dedicated head and neck sarcoma (HNS) multidisciplinary team (MDT) with a clear objective to provide formal access to super-specialist expertise in diagnosis, treatment planning and management of HNS. The aim of the study is to provide first results of a dedicated HNS MDT.
METHODS: All patients discussed between 2018 and 2022, in HNS MDT, with a new histologically confirmed HNS diagnosis were included in the study. Demographics, anatomic site, morphology, MDT recommendation, treatment details and outcomes were obtained from electronic patient records.
RESULTS: A total of 337 patients were discussed in the HNS MDT of which 178 patients were included in the study, with a median age of 53 years(range 2-94); 67 % were soft tissue sarcomas(STS) and 33 % were bone sarcomas(BS), of which 43 % and 71 % were high grade, respectively. 55 % BS and 39 % STS underwent surgery. 9 % of BS and 7 % of STS received adjuvant Proton Beam therapy. With a median follow-up of 2.16 years, recurrence was observed in 12 %, distant metastasis in 6 % of patients and overall survival was 72 %.
CONCLUSIONS: The HNS MDT provides expertise on diagnosis and multi-modality management of HNS. STS are more likely to be misdiagnosed. Atypical imaging characteristics should trigger a specialist referral. Adequate surgery at first presentation remains the mainstay of treatment and the strongest prognosticator of overall survival. Formation of an expert working group specific to HNS must work towards streamlining sarcoma care.
METHODS: All patients discussed between 2018 and 2022, in HNS MDT, with a new histologically confirmed HNS diagnosis were included in the study. Demographics, anatomic site, morphology, MDT recommendation, treatment details and outcomes were obtained from electronic patient records.
RESULTS: A total of 337 patients were discussed in the HNS MDT of which 178 patients were included in the study, with a median age of 53 years(range 2-94); 67 % were soft tissue sarcomas(STS) and 33 % were bone sarcomas(BS), of which 43 % and 71 % were high grade, respectively. 55 % BS and 39 % STS underwent surgery. 9 % of BS and 7 % of STS received adjuvant Proton Beam therapy. With a median follow-up of 2.16 years, recurrence was observed in 12 %, distant metastasis in 6 % of patients and overall survival was 72 %.
CONCLUSIONS: The HNS MDT provides expertise on diagnosis and multi-modality management of HNS. STS are more likely to be misdiagnosed. Atypical imaging characteristics should trigger a specialist referral. Adequate surgery at first presentation remains the mainstay of treatment and the strongest prognosticator of overall survival. Formation of an expert working group specific to HNS must work towards streamlining sarcoma care.
摘要：
目标：全球，头颈部肉瘤的治疗途径仍不清楚。2018年，伦敦肉瘤服务（LSS）成立了专门的头颈部肉瘤（HNS）多学科团队（MDT），其明确目标是正式获得诊断方面的超级专家专业知识。HNS的治疗计划和管理。该研究的目的是提供专用HNSMDT的初步结果。
方法：2018年至2022年期间讨论的所有患者，在HNSMDT中，一项新的组织学证实的HNS诊断纳入研究.人口统计,解剖部位,形态学,MDT建议，治疗细节和结局来自电子病历.
结果：在HNSMDT中总共讨论了337例患者，其中178例患者被纳入研究，年龄中位数为53岁（范围2-94）；67％为软组织肉瘤（STS），33％为骨肉瘤（BS），其中43%和71%是高级的，分别。55％的BS和39％的STS接受了手术。9%的BS和7%的STS接受辅助质子束治疗。中位随访时间为2.16年，12％观察到复发，6％的患者发生远处转移，总生存率为72％。
结论：HNSMDT为HNS的诊断和多模态管理提供了专业知识。STS更容易被误诊。非典型的影像学特征应触发专家转诊。初次就诊时的适当手术仍然是治疗的主要手段，也是总体生存率的最强预测指标。成立专门针对HNS的专家工作组必须致力于简化肉瘤护理。
方法：2018年至2022年期间讨论的所有患者，在HNSMDT中，一项新的组织学证实的HNS诊断纳入研究.人口统计,解剖部位,形态学,MDT建议，治疗细节和结局来自电子病历.
结果：在HNSMDT中总共讨论了337例患者，其中178例患者被纳入研究，年龄中位数为53岁（范围2-94）；67％为软组织肉瘤（STS），33％为骨肉瘤（BS），其中43%和71%是高级的，分别。55％的BS和39％的STS接受了手术。9%的BS和7%的STS接受辅助质子束治疗。中位随访时间为2.16年，12％观察到复发，6％的患者发生远处转移，总生存率为72％。
结论：HNSMDT为HNS的诊断和多模态管理提供了专业知识。STS更容易被误诊。非典型的影像学特征应触发专家转诊。初次就诊时的适当手术仍然是治疗的主要手段，也是总体生存率的最强预测指标。成立专门针对HNS的专家工作组必须致力于简化肉瘤护理。
