The istituto rizzoli-beretta experience with osteosarcoma of the jaw

Abstract

Twenty‐eight osteosarcomas (OS) of the jaw were reported. There were 15 male and 13 female patients (age range, 9 to 68 years; mean, 36.9 years); 57.1% of the patients were older than 30 years of age. Swelling was the most frequent symptom; it was reported on an average of 6 months before diagnosis. Most of the tumors of the maxilla (eight patients) occurred in the alveolar ridge (six of eight). In the mandible (20 patients), the body was the preferred site (11 of 20). Radiographically most of the lesions were either lytic and sclerotic or only lytic. Histologically, 12 cases (42.9%) were osteoblastic osteosarcoma, ten (35.8%) were chondroblastic, four (14.3%) were fibroblastic, and two (7%) were round cell OS. Of the 28 cases, three (10.7%) were low grade, and 25 (89.3%) were high grade. Thirteen patients had intralesional surgery, and 13 had marginal surgery as their initial treatment. Recurrence was the rule in the first group, and it was 69% in the second group. Twenty patients (71%) died, and eight are alive. Of these, two are alive with disease. In the six patients who are alive and disease‐free, all but one had marginal to wide surgical margins at the time of the first procedure or wide margins at the time of the recurrences along with chemotherapy or radiation therapy. In the patient in which the surgical margins were marginal, the lesion was small 2.5 × 2 cm. This patient was alive without evidence of disease after 9 years of follow‐up.

Osteosarcomas of flat bones in adolescents and adults

“…The gender ratio was 66% male and 34% female. Of these patients, 16 (16.6%) had biopsy-proven primary or secondary bone osteosarcoma arising in flat bones of the craniofacial region (mandible or maxilla), axial skeleton (vertebrae or ribs), appendicular skeleton (scapula, clavicle, ilium, ischium, or sacrum), or small bones of the feet. Follow-up ranged from 11 months to 209 months (median, 104 months) after diagnosis.…”

Osteosarcoma of the Jaw: Classification, Diagnosis and Treatment

“…Surgery has a crucial role as the ability to treat a patient rest on a combination of aggressive surgical resection and advanced reconstructive techniques. The single most important factor for deinite cure is radical resection [5,[7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] with particular atention to achieve clear margins, a diicult task in relation to the complex anatomy of the maxillofacial region [13,14,[20][21][22][23].…”

“…Positive margins are strongly associated with poor prognosis; unfortunately, marginal excision is unavoidable in some JOS due to anatomic diiculties [15].…”

“…Complete resection of tumors involving the maxilla can be technically challenging, so local recurrence is more frequent in maxillary than mandibular osteosarcomas and, considering both sites, more common than the occurrence of distant metastases [5,15,16].…”

“…The manuscript by Bertoni et al [15] reported the Istituto Rizzoli-Bereta experience with JOS. They treated 26 of 28 patients with surgery and two patients with RTx.…”