Neurosurgical Review

, Volume 40, Issue 3, pp 449–460 | Cite as

Multimodal treatment of craniofacial osteosarcoma with high-grade histology. A single-center experience over 35 years

  • Marton König
  • Terje A. Osnes
  • Ingvild Lobmaier
  • Bodil Bjerkehagen
  • Øyvind S. Bruland
  • Kirsten Sundby Hall
  • Torstein R. Meling
Original Article


High-grade craniofacial osteosarcoma (CFOS) is an aggressive malignancy with a poor prognosis. Our goals were to evaluate treatment outcomes in those treated at a single referral institution over 35 years and to compare our results to the available literature. A retrospective analysis of all 42 patients treated between 1980 and 2015 at Oslo University Hospital, Norway, identified in a prospectively collected database, was conducted. Mean follow-up was 79.6 months. Overall survival at 2 and 5 years was 70.5 and 44.7%, respectively. The corresponding disease-specific survival rates were 73.0 and 49.8%. Treatment was surgery only in eight cases. Additional therapy was administered in 34 patients: chemotherapy in nine, radiotherapy in seven, and a combination of these in 18 cases. Stratified analysis by resection margins demonstrated significantly better survival at 2 and 5 years after radical surgical treatment. Neoadjuvant chemotherapy and subsequent adequate surgery resulted in better survival than surgery alone. Half of the patients either had a primary or familial cancer predisposition. This is the largest single-center study conducted on high-grade CFOS to date. Our experience indicates that neoadjuvant chemotherapy with complete surgical resection significantly improved survival, compared to surgery alone.


Osteosarcoma Surgical resection Craniofacial bones Multidisciplinary approach Multimodal treatment Survival 



The authors would like to thank Dr. Kjetil Berner and Dr. Olga Zaikova for their valuable feedback. They would also like to extend their gratitude to Trine Thoresen for maintaining the sarcoma database at the Norwegian Radium Hospital.

Conflict of interest

The authors declare that they have no conflict of interest.


This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Ethical approval

This study was approved by the data protection official at OUH. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study does not contain any studies with animals performed by any of the authors.

Informed consent

For this type of study, formal consent is not required.


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© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Department of NeurosurgeryOslo University Hospital - RikshospitaletOsloNorway
  2. 2.Department of NeurologyOstfold Hospital TrustGralumNorway
  3. 3.Institute of Clinical MedicineUniversity of OsloOsloNorway
  4. 4.Department of OtorhinolaryngologyOslo University Hospital - RikshospitaletOsloNorway
  5. 5.Department of PathologyOslo University Hospital - RadiumhospitaletOsloNorway
  6. 6.Department of OncologyOslo University Hospital - RadiumhospitaletOsloNorway

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