National cancer data base report on osteosarcoma of the head and neck

Russell B. Smith, Louis W. Apostolakis, Lucy Hynds Karnell, Brenton B. Koch, Robert A. Robinson, Weining Zhen, Herman R. Menck, Henry T. Hoffman

Research output: Contribution to journalArticlepeer-review

117 Scopus citations


BACKGROUND. Osteosarcoma is the most common primary bone malignancy overall but is encountered infrequently in the head and neck. Limited data are available on the significance of prognostics factors and results of therapy for patients with head and neck osteosarcoma (HNOS). It is known that surgical therapy is critical to successful outcome. The impact of adjuvant chemotherapy has not been defined well. METHODS. The National Cancer Data Base has collected data on cases of HNOS by voluntary accrual from participating hospitals. This database was used to assess patient demographics, tumor characteristics, treatment, and outcome for an 11-year period extending from 1985 to 1996. RESULTS. The data set contained 496 cases of HNOS. Overall, the 5-year disease-specific survival rate was 59.7%. Factors associated with a poor prognosis were age older than 60 years; nonmandibular tumor location; tumor size > 6 cm; histologic type of osteoblastic, not otherwise specified (NOS); advanced disease stage; nonsurgical initial therapy; and positive margins of resection. Increased use of multimodality therapy was noted during the later years of the study. No substantial difference in the 5-year survival rate was noted between treatment with surgery alone (74.7%) and surgery with adjuvant chemotherapy (71.3%), despite the greater prevalence of tumors with poor prognostic factors in the surgery and adjuvant chemotherapy group. CONCLUSIONS. Surgery with clear margins is an important factor in successful therapy for patients with HNOS. Improved survival has been noted within the last 2 decades compared with historic controls. Multiple negative prognostic factors have been identified and should be considered in treatment planning. The role of chemotherapy has not been defined well, but its incorporation into treatment of patients with high-risk tumors may improve survival.

Original languageEnglish (US)
Pages (from-to)1670-1680
Number of pages11
Issue number8
StatePublished - Oct 15 2003


  • Chemotherapy
  • Head and neck neoplasms
  • National Cancer Data Base
  • Osteosarcoma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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