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

Neurosurg Rev. 2017 Jul;40(3):449-460. doi: 10.1007/s10143-016-0802-z. Epub 2016 Nov 17.


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.

Keywords: Craniofacial bones; Multidisciplinary approach; Multimodal treatment; Osteosarcoma; Surgical resection; Survival.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Combined Modality Therapy
  • Facial Neoplasms / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoadjuvant Therapy
  • Neurosurgical Procedures
  • Osteosarcoma / surgery
  • Osteosarcoma / therapy*
  • Radiotherapy / methods
  • Retrospective Studies
  • Skull Neoplasms / surgery*
  • Survival Analysis
  • Treatment Outcome
  • Young Adult