Head and neck osteosarcomas: Analysis of treatment trends and survival outcomes in the United States (2004–2016)

Background Head and neck osteosarcoma (HNOS) is a rare primary bone tumor with limited data to guide treatment approaches. Methods The NCDB was used to identify patients diagnosed with HNOS. Kaplan–Meier and Cox multivariate regression were used to examine the impact of each treatment on overall survival (OS). Results We identified 821 patients diagnosed with HNOS. Utilization of neoadjuvant chemotherapy + surgery increased from zero cases in 2004 to 24% of cases in 2016. Among surgically treated patients, 5‐year OS was 55.8% (CI: 51.7–60.1%). No difference was seen in OS between each treatment cohort on multivariate analysis. However, neoadjuvant chemotherapy + surgery + adjuvant chemotherapy had improved 18‐month survival compared to surgery alone (95.8% vs. 78.5%, p = 0.031). Conclusions Our study demonstrated no survival benefit in perioperative chemotherapy or radiation therapy; however, short‐term survival improvement in patients receiving both neoadjuvant and adjuvant chemotherapy displays promise and requires further investigation.