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

Multimodal Treatment of Craniofacial Osteosarcoma With High-Grade Histology. A Single-Center Experience Over 35 Years

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Multimodal Treatment of Craniofacial Osteosarcoma With High-Grade Histology. A Single-Center Experience Over 35 Years

Marton König et al. Neurosurg Rev. .

Abstract

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.

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