J Korean Assoc Oral Maxillofac Surg.  2017 Oct;43(5):312-317. 10.5125/jkaoms.2017.43.5.312.

Osteosarcoma of the jaws in Koreans: analysis of 26 cases

• Jeong HI
• Lee MJ
• Nam W
• Cha IH
• Kim HJ

• KMID: 2393596
• DOI: http://doi.org/10.5125/jkaoms.2017.43.5.312

Abstract

OBJECTIVES
In order to assess clinical behavior, response to treatment, and factors influencing prognosis of Korean patients with osteosarcoma of the jaws (OSJ).
MATERIALS AND METHODS
A retrospective study of clinical, and pathological records of 26 patients with OSJ treated at the Department of Oral and Maxillofacial Surgery in Yonsei University Dental Hospital from 1990 to March 2017.
RESULTS
Of 26 patients, there were 9 men (34.6%) and 17 women (65.4%). Twenty-one of 26 patients had osteosarcoma of the mandible, and 5 of 26 patients had osteosarcoma of the maxilla. The histopathology of OSJ is highly variable, ranging from chondroblastic type (6 out of 26), osteoblastic type (10 out of 26), fibroblastic type (2 out of 26), to the rare variants like mixed type, small cell osteosarcoma types and more. All patients underwent gross total excision and only a few patients underwent neoadjuvant chemotherapy. Postoperative chemotherapy was given to most of the patients as adjuvant treatment or in combination with radiotherapy. The overall survival rate was 73.1% with an overall 2-year survival rate of 83.3%. The overall 5-,10-,15-year survival rates in this study were 73.5%, 73.5%, 49%, respectively. Using Kaplan-Meier analysis with log rank tests, the size of tumor (T-stage), and resection margins were found to affect the survival rate significantly. The chemotherapy was not significantly associated with improved survival rate.
CONCLUSION
Surgical resection with a clear margin is the most important factor in disease survival. The role of chemotherapy and radiotherapy in OSJ remains controversial, and deserves further studies.

Keyword

Osteosarcoma; Maxillofacial; Survival; Mandible; Maxilla

MeSH Terms

Chondrocytes
Drug Therapy
Female
Fibroblasts
Humans
Jaw*
Kaplan-Meier Estimate
Male
Mandible
Maxilla
Osteoblasts
Osteosarcoma*
Prognosis
Radiotherapy
Retrospective Studies
Surgery, Oral
Survival Rate

Figure

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  Fig. 1 Kaplan-Meier survival curve. Overall survival; 2-year survival=83.3%, 5-year survival=73.5%, 15-year survival=49%.

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  Fig. 2 Kaplan-Meier survival curve. Overall survival by T-stage (size of tumor). P=0.000385.

• 

  Fig. 3 Kaplan-Meier survival curve. Overall survival by margin status. P=0.001.

• 

  Fig. 4 Kaplan-Meier survival curve. Overall survival by treatment regimen. P=0.009. (CTx: chemotherapy, RTx: radiotherapy)

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