Osteogenic Sarcoma of the Jaw: A 10-Year Experience

Background: Osteosarcomas (OS) of all sites account for approximately 40% to 60% of primary malignant bone tumors. About 10% of OS occur in the head and neck; most are located in the mandible or maxilla. Jaw lesions are diagnosed on average 2 decades later than their long bone counterparts, which have a peak incidence between the ages of 10 and 14 years. Head and neck OS are associated with a lower metastatic rate than long bone OS, and they have a better 5-year survival rate, ranging between 27% and 84%. Patients and Methods: We present our experience at the Department of Oral and Maxillofacial Surgery, University of Maryland, Baltimore, MD, with 16 patients with OS of the jaw during a period from 1993 to 2003. Results: In a retrospective chart review, 16 cases of OS of the jaw were identified. Patients ranged in age from 14 to 51 years (mean age, 41 years). The gender distribution consisted of 10 females and 6 males, at a ratio of 1.6:1. Evaluation of site distribution revealed a more frequent occurrence in the mandible than in the maxilla (9 and 7 cases, respectively). The main histologic subtype was chondroblastic (8 cases), followed by osteoblastic (4 cases). According to histologic grading, 8 tumors were high grade, 1 intermediate, 5 low grade, and 2 unknown. Overall, the primary treatment modality consisted of surgery in all 14 patients treated at the University of Maryland; 2 patients opted for treatment at other institutions. Chemotherapy, consisting primarily of cisplatin and Adriamycin (doxorubicin hydrochloride; Pharmacia, Kalamazoo, MI), was used as adjuvant treatment in 4 cases of high-grade OS. Follow-up ranges from 14 months to 108 months (mean, 46 months). To date, of the 14 patients treated at our institution, 12 (86%) had no evidence of disease at last appointment, and 2 patients died of the disease. Conclusion: In light of the rarity of this disease, this series represents a large single-center experience with OS of the jaw. Our data show an older patient population, different gender distribution, and higher survival rate compared with overall published reports.