OUTCOMES OF MAXILLOFACIAL OSTEOSARCOMA: A MULTICENTER RETROSPECTIVE ANALYSIS
XXIII. World Congress of Otorhinolaryngology Head and Neck Surgery, İstanbul, Türkiye, 9 - 13 Eylül 2026, ss.360, (Özet Bildiri)
- Yayın Türü: Bildiri / Özet Bildiri
- Basıldığı Şehir: İstanbul
- Basıldığı Ülke: Türkiye
- Sayfa Sayıları: ss.360
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- İstanbul Üniversitesi-Cerrahpaşa Adresli: Evet
Özet
BACKGROUND & AIM Craniofacial osteosarcoma is a rare malignancy comprising 6–9% of all osteosarcomas, presenting unique surgical and oncological challenges. This multicenter study evaluated clinicopathological features, treatment outcomes, and prognostic factors in patients with maxillary, mandibular, and skull base osteosarcoma. MATERIAL & METHODS Seventeen patients treated across three tertiary centers—Istanbul University-Cerrahpaşa (Medical Oncology), Marmara University (Plastic and Reconstructive Surgery), and Başakşehir Çam ve Sakura City Hospital, University of Health Sciences (Otorhinolaryngology)—were retrospectively analyzed. Tumor characteristics, treatment modalities, and surgical margin status were recorded. Disease-free survival (DFS) and overall survival (OS) were estimated by the Kaplan–Meier method. Prognostic factors were assessed using penalized Cox regression (Firth's correction). Median follow-up was 55 months (95% CI: 8.8–101.2). RESULTS Median age was 35 years (IQR: 29.5–52.5); 52.9% were male. Tumor locations were mandible (76.5%), maxilla (17.6%), and skull base (5.9%). Median tumor diameter was 6.6 cm; soft tissue invasion was present in 64.7%. Conventional high-grade osteosarcoma predominated (82.4%). Neoadjuvant chemotherapy was administered in 35.3%, with good pathological response (≥90% necrosis) in 33.3%. Surgery was performed in 88.2%, achieving R0 resection in 66.7%. Recurrence or progression occurred in 64.7%; 41.2% died during follow-up. Median DFS was 13.0 months (2-year: 46.7%; 5-year: 18.7%) and median OS was 40.2 months (2-year: 74.6%; 5-year: 33.6%). On univariable analysis, R1 margin (HR: 15.38, p=0.005), neoadjuvant chemotherapy (HR: 5.31, p=0.015), and cortical irregularity (HR: 4.40, p=0.034) were significantly associated with inferior DFS. Median DFS was 34.6 vs. 7.9 months for R0 vs. R1 resection (p=0.011). CONCLUSIONS Craniofacial osteosarcoma carries a poor prognosis with high recurrence rates. R0 surgical resection is the strongest determinant of disease-free survival. Cortical irregularity and neoadjuvant chemotherapy use—reflecting aggressive tumor biology—also predicted worse outcomes. These results highlight the critical role of multidisciplinary collaboration among medical oncology, reconstructive surgery, and head and neck surgery in optimizing patient outcomes