Krishnamurthy Arvind, Palaniappan Ravishankar
Surgical Oncology, Cancer Institute (WIA), 38, Sardar Patel Rd, Adyar, Chennai, 600036 India.
J Maxillofac Oral Surg. 2018 Mar;17(1):38-43. doi: 10.1007/s12663-017-1017-8. Epub 2017 Apr 27.
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.
To analyze the demographic profile, disease characteristics and survival outcomes of osteosarcoma of head and neck region.
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.
A total of 14 patients were treated in the said period with a mean age of 37 years. The most common site was mandible ( = 9 patients) followed by maxilla ( = 4) and paranasal sinuses ( = 1). Conventional osteoblastic variant of OS was the most common histological variant ( = 8) followed by the chondroblastic variant ( = 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.
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.
头颈部骨肉瘤具有独特的生物学特性，其临床行为和自然病程与躯干及四肢骨肉瘤不同。我们对这种恶性骨肿瘤的认识很大程度上基于单一机构的数据或登记处汇编的数据，因此临床实践指南似乎令人困惑且相互矛盾。
分析头颈部骨肉瘤的人口统计学特征、疾病特点及生存结局。
对2001年至2013年间在印度南部一家三级癌症中心接受根治性治疗的头颈部骨肉瘤患者进行回顾性分析。
在上述期间共治疗了14例患者，平均年龄37岁。最常见的部位是下颌骨（9例患者），其次是上颌骨（4例）和鼻窦（1例）。骨肉瘤的传统成骨型是最常见的组织学类型（8例），其次是软骨母细胞型（5例）。无病生存期的中位数为41.7个月，而我们患者队列的总生存期中位数为47.6个月。对各种预后因素的正式分析表明，只有术后切缘阳性是影响生存结局的唯一重要因素。
头颈部骨肉瘤最常累及颌骨，发病于生命的第四个十年。尽管本研究样本量较小，但确实凸显了切缘阴性切除作为头颈部骨肉瘤多模式治疗一部分的重要性。考虑到数据相对较少，需要开展多机构合作研究以完善头颈部骨肉瘤患者的治疗策略。
