title: Multimodal treatment of craniofacial osteosarcoma with high-grade histology. A single-center experience over 35 years.
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.
authors.affiliation: Department of Neurosurgery, Oslo University Hospital - Rikshospitalet, 4950 Nydalen, Oslo, 0424, Norway. m.s.s.konig@medisin.uio.no.|Department of Neurology, Ostfold Hospital Trust, 300, Gralum, 1714, Norway. m.s.s.konig@medisin.uio.no.|Institute of Clinical Medicine, University of Oslo, 1711 Blindern, Oslo, 0318, Norway. m.s.s.konig@medisin.uio.no.
authors.forename: Marton
authors.identifier: http://orcid.org/0000-0001-6242-9804
authors.initials: M
authors.lastname: König
authors.affiliation: Institute of Clinical Medicine, University of Oslo, 1711 Blindern, Oslo, 0318, Norway.|Department of Otorhinolaryngology, Oslo University Hospital - Rikshospitalet, 4950 Nydalen, 0424, Oslo, Norway.
authors.forename: Terje A
authors.initials: TA
authors.lastname: Osnes
authors.affiliation: Department of Pathology, Oslo University Hospital - Radiumhospitalet, 4950 Nydalen, Oslo, 0424, Norway.
authors.forename: Ingvild
authors.initials: I
authors.lastname: Lobmaier
authors.affiliation: Department of Pathology, Oslo University Hospital - Radiumhospitalet, 4950 Nydalen, Oslo, 0424, Norway.
authors.forename: Bodil
authors.initials: B
authors.lastname: Bjerkehagen
authors.affiliation: Institute of Clinical Medicine, University of Oslo, 1711 Blindern, Oslo, 0318, Norway.|Department of Oncology, Oslo University Hospital - Radiumhospitalet, 4950 Nydalen, Oslo, 0424, Norway.
authors.forename: Øyvind S
authors.initials: ØS
authors.lastname: Bruland
authors.affiliation: Department of Oncology, Oslo University Hospital - Radiumhospitalet, 4950 Nydalen, Oslo, 0424, Norway.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Sundby Hall
authors.affiliation: Department of Neurosurgery, Oslo University Hospital - Rikshospitalet, 4950 Nydalen, Oslo, 0424, Norway.|Institute of Clinical Medicine, University of Oslo, 1711 Blindern, Oslo, 0318, Norway.
authors.forename: Torstein R
authors.initials: TR
authors.lastname: Meling
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003131:Combined Modality Therapy; D005153:Facial Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D019635:Neurosurgical Procedures; D012516:Osteosarcoma / Q000601:surgery / Q000628:therapy*; D011878:Radiotherapy / Q000379:methods; D012189:Retrospective Studies; D012888:Skull Neoplasms / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
keywords: Craniofacial bones; Multidisciplinary approach; Multimodal treatment; Osteosarcoma; Surgical resection; Survival