Objective:

To analyze the epidemiology and outcomes of osteosarcoma and Ewing sarcoma of the skull in pediatric patients using the SEER database, addressing a significant gap in existing literature.

Key Findings:

• Total of 124 patients analyzed; 46% diagnosed with OSC and 54% with EWS, indicating a balanced representation.
• Overall survival rates were 90.3% at 1 year, 77.9% at 3 years, and 75.6% at 5 years, highlighting the need for targeted interventions.
• Younger patients (0-14 years) had significantly better survival rates than older adolescents (15-19 years) (P = 0.003), suggesting age-related treatment considerations.
• EWS patients had a higher survival rate compared to OSC patients (P = 0.004), emphasizing the importance of histological subtype in prognosis.
• Localized disease was associated with better survival outcomes compared to distant metastases (P = 0.003), underscoring the critical role of disease stage.

Interpretation:

Age, histological subtype, and disease stage at diagnosis are significant independent predictors of overall survival in pediatric patients with skull tumors, highlighting the need for tailored treatment strategies.

Limitations:

• Study limited to data available in the SEER database, which may not capture all cases, potentially leading to underreporting.
• Potential for incomplete data on treatment modalities and outcomes, which could affect the robustness of findings.

Conclusion:

This study provides valuable insights into the rare occurrences of osteosarcoma and Ewing sarcoma of the skull in children and adolescents, highlighting the importance of age and disease stage in survival outcomes, and suggesting avenues for future research.