Real-world impact of chemotherapy on overall survival in craniomaxillofacial osteosarcoma

Yi-Han Li; Liang Zheng; Guang-Can Chen; Yi-Ming Zhang; Yuan-Zhi Xu; Yi-Feng Huang

doi:10.1016/j.jormas.2024.101807

Real-world impact of chemotherapy on overall survival in craniomaxillofacial osteosarcoma

J Stomatol Oral Maxillofac Surg. 2024 Feb 29:101807. doi: 10.1016/j.jormas.2024.101807. Online ahead of print.

Authors

Yi-Han Li¹, Liang Zheng², Guang-Can Chen¹, Yi-Ming Zhang¹, Yuan-Zhi Xu³, Yi-Feng Huang⁴

Affiliations

¹ Department of Stomatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
² Department of First Dental Clinic, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China.
³ Department of Stomatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China. Electronic address: shxuyz1973@126.com.
⁴ Department of First Dental Clinic, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China. Electronic address: hyfdent@163.com.

PMID: 38431082
DOI: 10.1016/j.jormas.2024.101807

Abstract

Objectives: The goal of this study was to identify the survival benefit of chemotherapy in craniomaxillofacial osteosarcoma (CMFO) patients based on a US population.

Materials and methods: The Surveillance, Epidemiology, and End Results (SEER) database was used to select patients with CMFO from 1988 to 2016. Age and tumor size were grouped by X-tail. Cox analysis were used to estimate hazards ratios (HR) among patients. All of patients were divided into two cohorts by using Propensity Score Matching (PSM) method to evaluate the effect of chemotherapy. All prognostic factors were included in the nomograms which predict the median survival time.

Results: 410 patients were included in our study. The results of survival rate, Kaplan-Meier and Cox regression were showed no significant difference between the group of chemotherapy performed and the group without chemotherapy. PSM analysis also demonstrated the limited survival advantage of chemotherapy. Moreover, all factors were further incorporated to construct the novel nomograms and its concordance indices (C-index) for internal validation of OS prediction were 0.749 (95 %CI:0.731-0.767).

Conclusions: Our study did not show the advantage of chemotherapy on the overall survival outcome of CMFO. Although neoadjuvant chemotherapy was currently recommended in clinical treatment, more rigorous randomized controlled trials are still needed. Nomograms would assist clinicians in making more accurate survival evaluation and choosing the optimal medical treatment.

Keywords: Chemotherapy; Head and Neck cancer; Nomogram; Osteosarcoma; Propensity Score matching; SEER database.