Epidemiology, Risk Factors, and Histopathological Profile of Jaw Osteosarcoma in Northern Nigeria: A 15-Year Retrospective Multi-Centre Study

Jaw osteosarcoma is a rare but aggressive primary bone malignancy with distinct biological behavior compared to its long-bone counterpart, and data from sub-Saharan Africa remain sparse. This multi-centre retrospective cohort study documents the epidemiology, associated risk factors, histopathological subtypes, and survival outcomes of jaw osteosarcoma in the North Central and North West geopolitical zones of Nigeria over a 15-year period from 2009 to 2023. Four tertiary institutions contributed data, yielding 48 histologically confirmed cases. Patient demographics, tumor site (mandible versus maxilla), histopathological subtype (osteoblastic, chondroblastic, fibroblastic), surgical management, adjuvant therapy utilization, and two-year survival were analyzed. Results indicate that jaw osteosarcoma predominantly affected males in the third and fourth decades, consistent with the global pattern. The mandible was affected more frequently than the maxilla. Osteoblastic subtype was most prevalent at 54.2%. Prior Paget's disease and fibrous dysplasia were identified as associated conditions in a subset of cases. Surgical resection was the primary treatment in 79% of cases; however, adjuvant radiotherapy or chemotherapy was administered in only 35% due to resource limitations and patient refusal. Two-year overall survival was 43.8%, significantly below global figures, highlighting gaps in multimodal oncological care. The study makes a substantive contribution to the limited pool of African jaw osteosarcoma data and informs advocacy for improved oncology resources in northern Nigeria. Keywords: jaw osteosarcoma, northern Nigeria, mandible, survival, retrospective study.