(0752) Treatment and Outcome Profiles of Osteosarcoma of the Jaw: Determining Prognostic Factors

Introduction: Craniofacial osteosarcomas (CFO) exhibit distinct characteristics compared to osteosarcomas of the long bones. Current literature is scare for pediatric, adolescent, and young adult cases–especially relating to prognosticating factors and outcomes. This study investigates CFO of the jaw to examine patients' characteristics, treatment pathways, and survival outcomes. We hypothesized that age is a prognosticating factor in CFO management.

Methods: The NCI-SEER database from 2000-2020 was leveraged. All primary CFO of the jaw were included. Descriptive statistics were stratified by age group to highlight characteristics, treatment pathways, and outcomes. Multivariate Cox proportional hazard regression models accounted for age, tumor grade, chemotherapy, and surgical intervention for the primary outcome of mortality. Survival analysis and comparison of survival times among patient factors were performed using Kaplan-Meier curves and log-rank tests.

Results: A total of 562 CFO were analyzed and 278 (49%) patients survived during the study period, with most diagnoses occurring among adults (40%). Most patients were female (n=304, 54%), identified as white (n=427, 76%), and were non-Hispanic (n=448, 80%). With respect to treatment modalities (P < 0.05, for interventions across age groups), 104 (19%) underwent radiation, 186 (33%) received chemotherapy, and 340 (61%) had surgery. In a multivariate Cox regression controlling for confounding variables, pediatric age at diagnosis (HR 0.51) was protective, whereas geriatric age at diagnosis (HR 2.79) increased risk of mortality.

Conclusions: Our study confirmed that age is indeed a prognosticating factor that contributes to the outcomes of patients with CFO of the jaw when controlling for confounding variables. Moreover, there is a predilection for CFO of the jaw to occur most commonly well beyond the adolescent years, with the adult cohort having the highest proportion of diagnosis. The prognosis of individuals with CFO of the jaw may be related to their surgical status and chemotherapy regimen as well as their age.