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Soft tissue sarcomas of the head and neck region: clinical and histopathological study of 39 patients

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Markowski J., Długosz-Karbowska A., Ciupińska M., Smółka W., Dobrosz Z., Ślaska-Kaspera A., Lesniewska-Skowerska O., Likus W., Mazurek K.
Polish Journal of Otolaryngology
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2024
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vol. 78
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issue 4
21-28
EN
Introduction: Soft tissue sarcomas (STS) constitute about 1–2% of all malignant tumors, with approximately 10% of them located in the head and neck region. Aim: The aim of this study was the assessment of treatment efficiency in head and neck STS of adult patients of the ENT Department of Medical University of Silesia, treated surgically in the period 1980–2023. Materials and methods: Retrospective analysis of 39 patients with the diagnosis of head and neck STS. Results: Histopathological examination showed 21 different types of STS located most commonly in: paranasal sinuses (13 cases), orbital cavity (6 cases), nasal cavity (3 cases), and larynx (3 cases). Other locations: parapharyngeal space, parotid gland, nasal septum, bridge of the nose, soft and hard palate, mandibular mucosa, tongue, auricle, palatine tonsil, and cheek. All those patients underwent chemoradiation as postoperative treatment. Radical surgical procedure was achieved in 32 patients (82%). However, in 11 patients (28%), microscopic examination did not confirm radical resection (R1 – PSM – positive surgical margin). In 7 patients (18%), the surgical procedure turned out to be not radical on macroscopic examination (R2). Dissemination of neoplasms (distant metastases) was found in 7 patients (18%). Five-year survival time without local recurrence was achieved in 25 patients (64%). The most frequent reason for unsuccessful interventions was local recurrence noted in 18 patients (46%), while distant metastases occurred in 9 patients (23%). Conclusions: The basic procedure in the treatment of STS is radical surgery combined with preoperative or postoperative radiotherapy and/or chemotherapy and, in case of a metastasis, surgical removal thereof. Despite the fact that sarcomas are rare tumors, they remain a challenge for head and neck surgery. Recurrence rates and mortality remain high due to the high degree of malignancy.
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Assessment of connective tissue metabolism in patients with head and neck malignancies treated with radiotherapy

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Mazurek K., Likus W., Siemianowicz K., Wiechec E., Kwiatkowski R., Pierzchała E., Wcisło-Dziadecka D., Markowski J.
Polish Journal of Otolaryngology
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2023
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vol. 77
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issue 5
23-29
EN
Introduction: Despite the use of highly specialized irradiation techniques in the treatment of head and neck tumors, it is still impossible to selectively destroy cancer cells without damaging normal structures, including connective tissue cells. Aim: The aim of the study was to analyze the concentration of degradation markers such as collagen type I (carboxyterminal telopeptide of type I collagen; ICTP) and elastin (elastin-derived peptides; EDPs) as well as selected metalloproteinases (MMP-1, MMP-2, MMP-9) in patients with head and neck malignancies undergoing radiotherapy. Material and methods: The test group consisted of 56 men, who underwent radical or palliative radiotherapy. The concentrations of ICTP, EDPs, MMP-1, MMP-2, MMP-9 were determined in three blood samples collected from patients prior to radiotherapy, immediately after its completion and 3 months after the therapy. Results: Both radical and palliative radiotherapy contribute to a significant increase in the concentration of EDPs. At the time of healing of post-irradiation lesions, the level of EDPs was reduced in both groups. The ICTP concentration was not affected by radiotherapy. No significant differences were observed in the concentration of MMP-1 and MMP-2 before and after radiotherapy. Radical radiotherapy caused a statistically significant late reduction in the concentration of MMP-9. The lowest concentrations of MMP-1, MMP-2, MMP-9 in the serum of patients qualified for palliative radiotherapy were recorded in a samples collected three months post-irradiation. Conclusions: The degradation markers of key extracellular matrix structural proteins may be helpful tools in the objective assessment of radiation-induced injuries to the connective tissue.
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