Oral and maxillofacial surgery training in Ireland: the Galway experience

Introduction/aims: The aim of this study was to analyse retrospectively the survival outcomes in correlation with the status of resection margins in a series of head and neck bone sarcomas. Materials/methods: Fifty four cases were treated during a period of 13 years within the setting of the London sarcoma service at UCLH. Follow-up data was recorded in 51 cases (range: 4 months to longer than 10 years). SPSS was used for statistical analysis. Log-rank test was employed to compare survival probabilities (Kaplan–Meyer). Results/statistics: The patients’ age ranged from 9 to 81 years, with a mean of 41 years. The mandible was affected in 29 cases (54%). The osteoblastic osteosarcoma was the most predominant histological type. The vast majority of cases were high grade (91%). The mainstay treatment approach consists of neoadjuvant combination chemotherapy followed by surgery and postoperative chemotherapy. The mesenchymal origin of sarcomas, the pattern of disease spread and the different extent of cancellous bone infiltration in bone sarcomas, as opposed to carcinomas render their surgical approach challenging. In our series the 2and 5-year overall survival (OS) rates were 91% and 73% respectively. The 5-year OS in bone sarcoma cases where clear surgical margins were achieved was 83%. Neoand adjuvant chemotherapy may have a role to play in advanced disease where surgical ablation can be challenging. Clinical relevance: We discuss the principles of the surgical management and the importance of resection margins in head and neck sarcomas.