Twenty-four patients were enrolled with mean age 37.7 years (range 17–80). Female gender was predominant (15/24) representing 62.5% (Table 1). The commonest site was maxilla as 9 patients presented with maxillary lesion (37.5%) divided as 3 maxillary osteosarcoma and 6 maxillary soft tissue sarcomas. Neck was the second common presented site (12.5%) (Fig. 1).

Shows anatomical sites of tumor presentation

Rhabdomyosarcoma and osteosarcoma were the most common pathological subtypes with equal presentation by 4 patients for each (16.7%) (Fig. 2). Less common presentation of Dermatofibrosarcoma protuberans (DFS), angiosarcoma, synovial sarcoma and fibrosarcoma (8,3% for each).

Shows pathological subtypes presentation

Regarding TNM staging, T2N0M0 was most common presenting stage (13 patients). T2-stage was the tumor stage in 54.2% of patients and less common T3- stage in 25% of patients. Twenty patients presented with negative LN affection 20/24 (83.3%). At presentation, 23/24 patients showed localized disease (95.8%), while 1/24 patient (4.2%) was metastatic to bone. Mitotic count score 1 was more common than score 2 (58.3% vs 41.7%). Fourteen patients’ tumor samples showed no tissue necrosis by pathological examination. Grade II had the upper hand by both TNM grading and FNCLCC grading (66.7%, 45.8% respectively) (Table 2).

Primary surgical treatment was done for 20 patients (83.33%) with R0 margin was achieved in 6 patients (25%), R1 margin in 11 patients (45.8%) and only 3 patients had R2 resected margins (12.5%). Radiotherapy was given as adjuvant treatment in 9/24 patients, as definitive in 2/24 and as palliative in one patient.

Chemotherapy was given in 5 patients as adjuvant chemotherapy and 3 patients received neoadjuvant chemotherapy. The main chemotherapy protocol used was VAC (vincristine, adriamycin, cyclophosphamide) as was given to 4 patients. Two patients received (cisplatin and adriamycin) combination protocol, one received (ifosfamide and adriamycin) combination protocol and one received VAC-IE (vincristine, adriamycin, cyclophosphamide alternating with ifosfamide, etoposide). Eight patients had local recurrence (8/20) and 3 systemic metastasis (3/23). By the end of the study, 17 patients were still alive (70.8%) (Table 3).

Mean time to relapse (TTR) of studied patients was 39.117 months with 95% CI (26.708 to 51.526), mean time to local relapse was 41.76 months with 95% CI (29.561 to 53.962) while mean time to systemic relapse was 56.08 months with 95% CI (46.790 to 65.369) (Table 4).

Regarding overall survival (OS) of patients of our study, Mean OS was 47.223 months with 95% CI (36.668 to 57.778) (Table 5, Fig. 3). The tumor grade, necrosis, margin, and adjuvant chemotherapy showed a trend to improve the OS but did not reach statistical significance, which may be related to the small sample size, and the 5-year OS was 65.4%. So, correlative survival analysis between different clinic-pathological factor and survival was difficult.

Overall survival curve of studied patients according to Kaplan Mayer analysis