In this study of patients with retroperitoneal, complete resection and liposarcoma histology are prognostic factors related to the disease-free and overall survival. Patients approached with curative intent should undergo aggressive attempts at complete surgical resection.

Introduction Among all head and neck tumors, only 0.5% occur in the parapharyngeal space and 80% are benign tumors. Surgery is the cornerstone of treatment. The deep location of this space and surrounding structures has given rise to a large number of surgical approaches for resection of parapharyngeal neoplasms. Our experience using the submandibular transcervical approach on 14 patients who had surgery upfront for treatment of these lesions is described. Material and methods This is a retrospective, descriptive case-series analysis of patients with parapharyngeal space tumors treated from January 2009 to July 2016, in whom carotid body tumors were excluded. Fourteen patients were included, 11 females (76.9%) and 3 males (23.1%), with a mean age of 46.9 years (SD 14.85). Results The most common symptom reported at patient's presentation to our clinic was a foreign body sensation in the oropharynx and pain. Navigation-guided surgery was used in two cases. Mean tumor size was 4.7 cm (SD 1.785). Complete resection of lesions was performed in all cases, and the major complication was massive bleeding in one case (7.1%). Conclusion According to the present analysis, the submandibular transcervical approach is an effective and safe technique that allows resection of large parapharyngeal tumors, even those close to the skull base. It has minimal complication rate, prevents morbidity associated mandibulotomy and allows extension to a transparotid, transmandibular and even to an infratemporal fossa approach. Navigation is indicated in tumors \ 2 cm. The submandibular transcervical approach should be considered upfront for neoplasms B 7 cm, preferentially C 0.5 cm distant from skull base.

Purpose/Objective(s): Malnutrition is a common complication for head and neck cancer (HNC) patients receiving radiation therapy (RT) or chemoradiation therapy (CRT). The Academy of Nutrition and Dietetics (AND) and the American Society of Parenteral and Enteral Nutrition (ASPEN) define moderate and severe malnutrition as the presence of 2 or more of the following: inadequate energy intake, weight loss, loss of body fat, loss of muscle mass, fluid accumulation, or reduced grip strength. In malnutrition, decreased muscle function may respond more quickly to nutritional deprivation than changes in weight. Research suggests that grip strength is a feasible tool for the bedside assessment of muscle function. The purpose of this study was to implement grip strength assessment as part of the nutrition assessment for HNC patients receiving RT or CRT and to investigate the relationship between grip strength and weight loss before and after 7 weeks of RT. Materials/Methods: Grip strength, assessed by dynamometry, and weight were recorded the first and last week of RT. Each hand was measured 3 times and the average was calculated. Hand dominance was noted. Subjects were classified as malnourished if they met the AND/ASPEN malnutrition criteria for weight loss and reduced grip strength. Reduced grip strength was defined as a grip strength 2 standard deviations (SD) below the normative standards provided with the dynamometer. Descriptive statistics were used to describe the subject population, changes in grip strength, and changes in weight. Correlation between change in grip strength and change in weight was performed using the Pearson correlation. Results: Eleven subjects, with a median age of 59 years (53-74), received RT (nZ4) or CRT (nZ7). Mean change in grip strength for the left hand was-1.0AE3.8 kg (SD) and for the right hand was-0.7AE5.6 kg (SD). The mean weight loss was 6.6AE6.4 kg (SD). Decreased grip strength correlated weakly with weight loss for both the left (rZ0.248, 90% confidence interval [CI]-0.205-0.501, PZ.462), and right hand (rZ0.180, 90% CI-0.396-0.686, PZ.596). Two subjects (18%) at the initial treatment visit and 1 subject (9%) at the last treatment visit qualified as malnourished. Conclusion: Although this study found no statistical correlation between weight loss and grip strength in the small series of HNC patients receiving RT or CRT, collecting data on grip strength using the dynamometer proved feasible. To more accurately diagnose malnutrition using the criteria of reduced grip strength, further research is needed to establish grip strength reference ranges.