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Head & Neck

OMS and Other Dental Specialists

Session: Oral Abstract Session Two

SA2 - Prognostic Indicators in Pediatric Head and Neck Sarcoma: A 17-Year Review

Friday, September 13, 2024
2:45 PM – 2:55 PM EDT
Location: W315B, Orange County Convention Center
2024 Oral Abstract Winner

    Oral Abstract Presenter(s)

  • RP

    Raina Patel

  • Tayla Moshal

    Research Fellow
    Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles
    Los Angeles, California

    • Co-Author(s)

  • Idean Roohani, BS

    Research Fellow
    Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles
    Los Angeles, California

  • Marah Jolibois, MS (she/her/hers)

    Research Fellow
    Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles
    Los Angeles, California

  • Sasha Lasky, BS

    Research Fellow
    Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles
    South Pasadena, California

  • Simon Youn, MD DDS

    Oral Maxillofacial Surgery Resident
    LA General Medical Center
    Los Angeles, California

  • MU

    Mark M. Urata, DDS, MD

    Plastic Surgeon Attending
    Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles
    Los Angeles, California

  • Jeffrey A. Hammoudeh, DDS, MD

    Plastic Surgeon Attending
    Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles
    Los Angeles, California

Abstract:

Background: Sarcomas account for 12.5% of pediatric head and neck cancers (HNC). These tumors are often aggressive and can have high associated morbidity and mortality. Their rarity contributes to the paucity of literature to guide treatment and predict outcomes. Thus, this study aims to identify prognostic indicators in pediatric head and neck sarcomas.

Methods: This retrospective review included patients with head and neck sarcomas treated at a tertiary pediatric hospital between 2006 and 2024. Patient demographics, tumor characteristics, treatment modality (e.g., surgery, chemotherapy, and radiation), and surgical margins were collected. The primary outcome was 5-year survival. Kaplan-Meier analysis using the log-rank test was used to compare the predicted survival rates between various risk factors while adjusting for metastatic disease.

Results: In total, 54 patients had HNC sarcomas, most commonly rhabdomyosarcoma (55.6%), followed by fibrosarcoma (16.7%), osteosarcoma (9.3%), and Ewing sarcoma (7.4%). The mean age at diagnosis was 7.4 ± 5.7 years. The mean follow-up time was 7.1 ± 4.4 years. The overall 5-year survival rate was 76.7%. When stratified by treatment modality, the 5-year survival rates were 93.8% for surgery alone, 67.7% for surgery + radiation, and 59.3% for radiation alone (P = .110). Compared to patients who underwent surgical resection with R1/2 margins, those who achieved R0 margins had significantly higher 5-year survival rates (100.0% vs. 73.6%; P = .024). Patients treated with early surgical intervention rather than neoadjuvant chemoradiation had significantly higher 5-year survival rates (90.9% vs. 60.0%, P = .040).

Conclusion: Early surgical intervention with R0 margins resulted in significantly higher survival rates in pediatric patients with head and neck sarcomas. Continued investigation of these HNCs in the pediatric population is encouraged for a more comprehensive understanding of treatment outcomes and to better guide informed decision-making.

References:
1. Schwartz, I., Hughes, C., & Brigger, M. T. (2015). Pediatric head and neck malignancies: incidence and trends, 1973-2010. Otolaryngology--Head and Neck Surgery: Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, 152(6), 1127–1132.
2. Park JT, Roh JL, Kim SO, et al. Prognostic Factors and Oncological Outcomes of 122 Head and Neck Soft Tissue Sarcoma Patients Treated at a Single Institution. Ann Surg Oncol. 2015;22(1):248-255.