Head and neck sarcomas: the first report addressing the duration of symptoms and diagnostic work up

Abstract

Background: Head and neck sarcomas are rare and difficult to diagnose and manage.

Aim: To describe a population of patients with head and neck sarcomas focusing on the effect of symptom duration and time to diagnosis on mortality and recurrence risk.

Materials and methods: Fifty-one patients treated in our department between 1998–2013 were retrospectively included. Patient and tumour characteristics as well as dates of interest were obtained from sarcoma registries, charts and pathology records. The effect of symptom duration and time to diagnosis on mortality and risk of recurrence was tested by multivariate analysis.

Results: There was a wide range in symptom duration (1–144 months, median 5) and time for diagnosis (0–234 days, median 14) without significant effect on overall mortality, disease-specific mortality or risk of recurrence. Chondrosarcomas in the larynx dominated among the patients with the longest diagnostic duration.

Conclusion and significance: The diagnostic process is challenging and in some cases of extremely long duration without effect on mortality. The symptom duration and time to diagnosis in relation to mortality and risk of recurrence has not previously been described. Early biopsy, better imaging and advanced pathological techniques can hopefully speed up the diagnostic process and reduce morbidity and mortality.

Chinese abstract

背景：头颈部肉瘤很少见, 很难诊断和治疗。

目的：描述一组头颈部肉瘤患者, 重点关注症状持续时间和诊断时间对死亡率和复发风险的影响。

材料与方法：回顾性分析1998年至2013年间在我科接受治疗的51例患者。从肉瘤登记、图表和病理记录中获取患者和肿瘤特征以及重要日期。通过多变量分析测试了症状持续时间和诊断时间对死亡率和复发风险的影响。

结果：症状持续时间（1-144个月, 中位数5）和诊断时间（0-234天, 中位数14）范围很广, 对总死亡率、疾病特异性死亡率或复发风险没有显著影响。在诊断时间最长的患者中, 喉部软骨肉瘤占多数。

结论和意义：诊断过程具有挑战性, 在某些持续时间非常长的病例中, 对死亡率没有影响。以前尚未描述与死亡率和复发风险有关的症状持续时间和诊断时间。早期活检、更好的影像和先进的病理学技术有望加快诊断过程并降低发病率和死亡率。

Keywords:

• Head and neck
• sarcoma
• cancer
• neoplasm
• time to diagnosis
• symptom duration

Acknowledgments

We thank Niels Henrik Bruun, Biostatistical Advisory Service, Department of Public Health, Aarhus University Hospital for statistical assistance.

Disclosure statement

The authors have declared no conflict of interest.