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Original Article
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Osteosarcoma of the jaw/craniofacial region
Outcomes after multimodality treatment
Article first published online: 20 APR 2009
DOI: 10.1002/cncr.24297
Copyright © 2009 American Cancer Society
Additional Information
How to Cite
Guadagnolo, B. A., Zagars, G. K., Raymond, A. K., Benjamin, R. S. and Sturgis, E. M. (2009), Osteosarcoma of the jaw/craniofacial region. Cancer, 115: 3262–3270. doi: 10.1002/cncr.24297
Publication History
- Issue published online: 15 JUL 2009
- Article first published online: 20 APR 2009
- Manuscript Accepted: 9 FEB 2009
- Manuscript Received: 29 JAN 2009
- Abstract
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Keywords:
- osteosarcoma;
- jaw;
- craniofacial bones;
- radiotherapy;
- local control
Osteosarcoma of the head and neck (OHN) is a rare presentation of osteosarcoma, and exhibits a clinical behavior and natural history that are distinct from those of osteosarcoma occurring in the trunk and extremity. Radical surgery is the mainstay of treatment in any attempt at curative management, although to the authors' knowledge, the role of radiotherapy (RT) has not been clearly defined to date. The current study was performed to evaluate outcomes in patients with OHN who were treated with surgery with or without RT.
Abstract
BACKGROUND:
The current study was performed to evaluate outcomes in patients with osteosarcoma of the head and neck (OHN) who were treated with surgery with or without radiotherapy (RT).
METHODS:
Between 1960 and 2007, 119 patients with OHN underwent macroscopic total resection with or without RT. The median age of the patients was 33 years (range, 7-77 years). Of these 119 patients 92 (77%) underwent surgery alone whereas 27 (23%) patients were treated with combined modality treatment (CMT) comprised of surgery and RT (median dose, 60 Gray [Gy]; range, 50-66 Gy).
RESULTS:
The median follow-up was 5.8 years. Overall survival (OS) rates at 5 years and 10 years were 63% and 55%, respectively. Corresponding disease‒specific survival (DSS) rates were 67% and 61%, respectively. Stratified analysis by resection margin status demonstrated that CMT compared with surgery alone improved OS (80% vs 31%; P = .02) and DSS (80% vs 35%; P = .02) for patients with positive/uncertain resection margins. Multivariate analysis indicated that CMT for patients with positive/uncertain resection margins improved OS (P < .0001). A total of 44 (37%) patients experienced local disease recurrence (LR) and 25 (21%) developed distant metastases (DM). There was no difference noted with regard to DSS if disease recurrence was isolated (LR vs DM: 26% vs 29%, respectively, at 5 years; P = .48) The use of CMT versus surgery alone improved local control (LC) (75% vs 24%; P = .006) for patients with positive/uncertain resection margins. The rate of surgical complications was 28% at 5 years. The rates of RT-associated complications were 40% and 47% at 5 years and 10 years, respectively.
CONCLUSIONS:
The results of the current study indicated that RT in addition to surgery improves OS, DSS, and LC for patients with OHN who have positive/uncertain resection margins. Cancer 2009. © 2009 American Cancer Society.