A comparison of malignant fibrous histiocytoma of head, neck and extremities

Objective To compare the epidemiology, local and regional invasion and prognosis of head and neck malignant fibrous histiocytoma (MFH) and extremity MFH. Methods Between January 1, 1972 and December 31, 1993, 173 patients with MFH (71 head and neck, 102 extremities and trunk) were referred to the Cancer Hospital for surgical treatment. They were 101 men and 72 women, with age ranging from 13 to 83 years (median: 45 years). The extent of surgery was classified into radical, wide and local resection. Results For head and neck, local recurrence of MFH after wide resection was 80.4% (37/46), compared with 36.4% (8/22) after radical surgery (P=0.000). The five-year survival was 50.79% in all the head and neck patients (74.75% in patients free of local recurrence, 37.74% in patients with local recurrence; P=0.0181), compared with 70.71% in extremity patients (P=0.0005). Repeated surgery after recurrence of MFH could cure 40.9% of the head and neck patients and 80.7% of the extremity patients.Conclusion Inadequate resection of head and neck MFH in initial surgery is associated with a high incidence of local recurrence, which is always correlated with worse prognosis. Repeated surgery for recurrent head and neck MFH is not as effective as for recurrent extremity MFH. Therefore, we suggest that the initial surgery for head and neck MFH should be as radical as allowed to avoid a possible local recurrence.