Osteosarcomas of the Head and Neck Region: A Case Series with a Review of Literature

Abstract

Background

Osteosarcomas of head and neck region have unique biology and exhibit a clinical behavior and natural history that is distinct from osteosarcomas of the trunk and extremities. Our understanding of this malignant bone tumor is largely based on data from single institutions or compiled from registries, and hence the clinical practice guidelines seem confusing and conflicting.

Aims and Objectives

To analyze the demographic profile, disease characteristics and survival outcomes of osteosarcoma of head and neck region.

Materials and Methods

Retrospective analysis of the patients treated for osteosarcoma of head and neck region with curative intent in the period between the years 2001–2013 at a tertiary cancer center from South India.

Results

A total of 14 patients were treated in the said period with a mean age of 37 years. The most common site was mandible (n = 9 patients) followed by maxilla (n = 4) and paranasal sinuses (n = 1). Conventional osteoblastic variant of OS was the most common histological variant (n = 8) followed by the chondroblastic variant (n = 5). The median disease-free survival was 41.7 months, whereas the median overall survival of our patient cohort was 47.6 months. A formal analysis of various prognostic factors showed only postoperative margin positivity to be the single important factor affecting the survival outcomes.

Conclusion

Head and neck osteosarcoma that most commonly afflicts the jaw bones occurs in the fourth decade of life. Despite being a small series, our study does highlight the importance of achieving a margin-negative resection as a part of the multimodality treatment of head and neck osteosarcomas. Considering the relative paucity of data, there is a need for multi-institutional collaborative studies to refine the therapeutic strategies for the management of patients with head and neck osteosarcomas.

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