1. Craniomaxillofacial osteosarcoma:the role of surgical margins
- Author
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Tom Böhling, Antti Mäkitie, Karri Mesimäki, Risto Kontio, Paula Lindholm, Peppi Koivunen, Mika Sampo, Kauko Saarilahti, Jaana Hagström, Department of Oral and Maxillofacial Diseases, HUS Head and Neck Center, Oral and Maxillofacial Surgery, Medicum, Department of Pathology, Tom Böhling / Principal Investigator, Department of Oncology, HUS Comprehensive Cancer Center, Department of Ophthalmology and Otorhinolaryngology, Korva-, nenä- ja kurkkutautien klinikka, and HUSLAB
- Subjects
Maxillofacial ,Survival ,medicine.medical_treatment ,Postoperative radiotherapy ,CRANIOFACIAL OSTEOSARCOMA ,head and neck ,surgery ,0302 clinical medicine ,PROGNOSTIC-FACTORS ,Finland ,NECK REGION ,Curative intent ,Osteosarcoma ,Margins of Excision ,JAWS ,Middle Aged ,3. Good health ,Treatment Outcome ,Curative treatment ,030220 oncology & carcinogenesis ,Oral Surgery ,Adult ,medicine.medical_specialty ,Adolescent ,Bone Neoplasms ,Maxillary Bones ,survival ,03 medical and health sciences ,Young Adult ,Head and neck ,medicine ,Humans ,HEAD ,Radical surgery ,maxillofacial ,radiotherapy ,Aged ,Retrospective Studies ,Radiotherapy ,business.industry ,Mean age ,030206 dentistry ,medicine.disease ,3126 Surgery, anesthesiology, intensive care, radiology ,313 Dentistry ,Surgery ,Radiation therapy ,Otorhinolaryngology ,EXPERIENCE ,Neoplasm Recurrence, Local ,business ,OSTEOGENIC-SARCOMA - Abstract
Background: Osteosarcomas (OS) in the craniomaxillofacial (CMF) region are typically diagnosed at later age than long-bone OS, but they are reported to have better 5-year survival. Curative treatment warrants wide surgical resection, which is often not possible in the CMF region. The purpose of this article is to present a nationwide series of CMF in Finland to discuss the role of surgery. Patients and methods: All 21 CMF OS patients managed in Finland from 1992 to 2009 were included. The mean age was 40 years (range 15e72). Data on patient and tumor characteristics, treatment modalities, and survival were recorded. All patients had a minimum follow-up of 5 years or until death. Results: OS was evenly represented in the mandible and maxillary bones, which together constituted 76% of all sites. Surgery with curative intent was carried out in 20 patients. Clear margins were achieved in only five cases. Eight (40%) of these 20 patients died due to OS, and their average survival time was 1.3 years. Seven (35%) out of the 20 patients received radiotherapy due to close/intralesional surgical margins, and four of them did not develop recurrences during the follow-up. Conclusions: The results suggest that postoperative radiotherapy may alter the prognosis in CMF OS, particularly in cases with close or intralesional margins. This may increase the survival rates achieved by prompt action in performing radical surgery. (C) 2019 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
- Published
- 2019