Prognostic factors of head and neck osteosarcoma: A 10-year retrospective study from a single institute

Head and neck osteosarcoma (HNOS) is a rare malignant bone tumor, comprising approximately 10 % of all osteosarcoma cases, with the mandible being the most commonly affected site. Surgery remains the cornerstone of treatment, and achieving negative margins is critical for improved prognosis. However, due to the rarity of HNOS, most studies suffer from limited sample sizes. This retrospective cohort study aims to evaluate the impact of various clinical and treatment factors on patient outcomes over 10 years.

A retrospective study was conducted. Data were collected from patients diagnosed with osteosarcoma and treated with primary tumor surgery at the Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, between 2009 and 2018. Demographic, clinical, pathological, and treatment variables were analyzed using univariate and multivariate methods to assess overall survival (OS), disease-free survival (DFS), local recurrence (LR), and metastasis (MT).

247 patients met the inclusion criteria, with 209 included in the follow-up analysis. Mandibular location, primary tumors, and negative surgical margins were significantly associated with improved OS and DFS. The female sex was linked to a lower risk of LR, while pathological grade III tumors predicted poorer OS and DFS. Positive margins significantly worsened OS and DFS and increased LR risk. Chemotherapy or radiotherapy did not significantly affect survival outcomes.

Mandibular location, primary tumors, and negative margins are favorable prognostic factors for HNOS. Pathological grade III and positive margins indicate poorer outcomes. Multimodal treatments did not demonstrate significant survival benefits.