Osteosarcoma of the head and neck region: lessons learned from a single-institution experience of 50 patients.

Abstract

Osteosarcoma of the head and neck region is a rare tumor and is a therapeutic challenge because of its aggressive nature and complex anatomical location. Standard management guidelines are lacking due to paucity of published data. Fifty patients with head and neck osteosarcoma treated at our institute from 1995 to 2004 were reviewed. There were 32 men and 18 women (median, 30 years). Mandible (56%) was the most common site. Chondroblastic (46%) was the most common histopathological variant. Treatment comprised multimodality approach using surgery (100%), radiotherapy (36%), and chemotherapy (58%). After a median follow-up of 16.6 months, 46% were alive and disease free. Median overall survival was 45.7 months, and progression-free survival was 13.7 months. Mandible and maxilla were favorable sites. Postoperative adjuvant radiotherapy improved local control in patients with adverse prognostic factors. Surgery remains the mainstay of the treatment of head and neck osteosarcoma. Adjuvant radiotherapy improves outcome in patients with adverse factors.