Multimodal treatment of craniofacial osteosarcoma with high-grade histology. A single-center experience over 35 years
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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.
KeywordsOsteosarcoma 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.
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.
For this type of study, formal consent is not required.
- 3.Fletcher C, Bridge J, Hogendoorn PC, Mertens F (2013) WHO classification of tumours of soft tissue and bone, 4th edn. International Agency for Research on Cancer, LyonGoogle Scholar
- 11.Fletcher C, Unni K (2002) Pathology and genetics of tumours of soft tissue and bone. IARC Press, LyonGoogle Scholar
- 12.Saeter G, Bruland O (1998) High-grade osteosarcoma: the scope beyond the classical patient. Towards the Eradication of Osteosarcoma Metastasis-An Odyssey 21-3Google Scholar
- 15.Cox D (1972) Regression models and life tables. J R Stat Soc B 34:187–220Google Scholar
- 53.Lim S, Lee S, Rha SY, Rho JK (2013) Craniofacial osteosarcoma: single institutional experience in Korea. Asia Pac J Clin OncolGoogle Scholar
- 70.Boon E, van der Graaf WT, Gelderblom H, Tesselaar ME, van Es RJ, Oosting SF, et al. (2016) Impact of chemotherapy on the outcome of osteosarcoma of the head and neck in adults. Head NeckGoogle Scholar
- 76.Bielack SS, Smeland S, Whelan JS, Marina N, Jovic G, Hook JM et al (2015) Methotrexate, doxorubicin, and cisplatin (MAP) plus maintenance pegylated interferon alfa-2b versus MAP alone in patients with resectable high-grade osteosarcoma and good histologic response to preoperative MAP: first results of the EURAMOS-1 good response randomized controlled trial. J Clin Oncol 33(20):2279–2287CrossRefPubMedPubMedCentralGoogle Scholar
- 77.Ferrari S, Smeland S, Mercuri M, Bertoni F, Longhi A, Ruggieri P et al (2005) Neoadjuvant chemotherapy with high-dose ifosfamide, high-dose methotrexate, cisplatin, and doxorubicin for patients with localized osteosarcoma of the extremity: a joint study by the Italian and Scandinavian Sarcoma Groups. J Clin Oncol 23(34):8845–8852CrossRefPubMedGoogle Scholar