Multidisciplinary treatment of XXXX : Patterns of failure and management of recurrence.

@entity5 @entity4236 @entity1 @entity129
PURPOSE: @entity4236 is an uncommon @entity5 of the head and neck for which there is no defined treatment protocol. The purpose of this study is to report our experience with the treatment and patterns of failure of this disease. METHODS AND MATERIALS: From 1994 to 2012, 37 previously unreported @entity1 with @entity4236 were evaluated, and 32 eventually treated for cure at 2 academic medical centers. All @entity1 were staged with Kadish criteria. The mean and median follow-ups were 96.1 and 76.5months respectively (range 6-240months). RESULTS: The Kadish stage was A in 6 @entity1 , B in 13 @entity1 , and C in 13 @entity1 . Four @entity1 were initially treated with concurrent chemo-radiation therapy. Twenty-eight @entity1 were treated with primary surgery. Two (2) underwent open medial maxillectomy and 26 underwent craniofacial resection (open - 17, endoscopic - 9). Three @entity1 received curative surgical resection only. Seven @entity1 failed either within the @entity129 or distantly, 6 of the 7 are dead of disease, 10-194months following initial treatment. Six @entity1 had isolated neck recurrences, 4/6 were salvaged with neck dissection and additional chemo-radiation and remain alive 30-194months following initial treatment. Estimated overall survival rate at 10years was 78% based on Kadish and T stages. CONCLUSION: In this retrospective analysis of 32 @entity1 , Kadish stage C and stage T3/T4 @entity5 were associated with worse outcome. Total radiation dose of 60Gy, margin status, @entity1 age, were not found to have significant prognostic value.
