Introduction:
Paediatric head and neck malignancies are a rare and heterogeneous group of tumours with diverse clinical presentations, pathological features and treatment pathways. As such, evidence to guide management remains limited, with most research studies focusing on individual tumour types. This study aimed to characterise the presentation, management and outcomes of paediatric head and neck cancers treated at a UK tertiary referral centre.
Methods:
A retrospective review was undertaken of paediatric patients managed through a tertiary head and neck oncology service over a 20-year period. Demographic, radiological, pathological, treatment and outcome data were collected from multidisciplinary databases and electronic records. Haematological malignancies were excluded. Descriptive statistical analysis was performed.
Results:
Thirty-seven patients were identified with a mean age at diagnosis of 8.5 years. Rhabdomyosarcoma was the most common histological diagnosis (22.2%), followed by acinic cell carcinoma (19.4%), mucoepidermoid carcinoma (13.9%) and papillary thyroid carcinoma (13.9%). The parotid gland was the most frequent primary site (n=12), followed by the thyroid (n=7). Surgery alone was the predominant treatment modality (62%), while 35% required multimodal therapy incorporating chemotherapy, radiotherapy or proton therapy. Postoperative complications occurred in 33.3% of surgically treated patients. A mortality rate of 11.1% was seen, all in patients with recurrent sarcoma.
Conclusions:
Paediatric head and neck cancers are uncommon and highly heterogeneous, requiring individualised multidisciplinary management. Salivary and thyroid malignancies demonstrated favourable outcomes following surgery, whereas soft tissue sarcomas were associated with higher recurrence rates and mortality. Collaborative multicentre studies are needed to optimise management strategies and improve long-term outcomes.
References
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