Osteosarcomas of the mandible: Multidisciplinary management of a rare tumor of the young adult a cooperative study of the GSF-GETO, rare cancer network, GETTEC/refcor and sfce

J. Thariat, T. Schouman, A. Brouchet, J. Sarini, R. C. Miller, H. Reychler, I. Ray-Coquard, A. Italiano, C. Verite, S. Sohawon, E. Bompas, O. Dassonville, S. Salas, K. Aldabbagh, P. Maingon, T. de la MotteRouge, J. E. Kurtz, J. Usseglio, P. Kerbrat, G. RaoulJ. P. Lotz, G. Bar-Sela, L. Brugières, L. Chaigneau, E. Saada, G. Odin, P. Y. Marcy, A. Thyss, M. Julieron

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

Background: Mandibular osteosarcomas (MOS) mostly affect young adults. Their treatment is extrapolated from that of extragnathic osteosarcomas. Material and methods: A retrospective multicooperative group study was conducted to determine the impact of chemotherapy, adjuvant radiation therapy and surgery on outcomes and to identify prognostic factors. This ethical committee-approved study included a centralized review of histology slides and operative reports. Results: Of 111 patients, 58.6% were male, median age 35 years (13%, ≤18 years). Histology was osteoblastic, chondroblastic, fibroblastic, conventional not otherwise specified and others in 39.6%, 30.6%, 8.1%, 12.6% and 8.0%, respectively. Pathological World Health Organisation grades were low, intermediate and high grade in 6.4%, 11.8% and 81.8%, respectively. Surgery was carried out for 94.5% of patients. Neoadjuvant chemotherapy (mixed protocols) was carried out in 93.1% of patients. Postoperative chemotherapy and radiotherapy were carried out in 54.7% and 23.8%, respectively. Median follow-up was 59.6 months (range). Five-year local control, metastasis-free, disease-free and overall survival rates were 64.6%, 68.9%, 53.2% and 69.2%, respectively. Survival was significantly associated with age, tumor size and surgery. Wide surgery with clear margins and free flap reconstruction was the strongest prognostic factor. Neoadjuvant chemotherapy improved disease-free and metastatic-free survival and increased clear margins rates from 50% to 68%. Intermediate grades behaved like high grades in terms of metastatic-free and disease-free survival.Conclusion: This homogeneous series is the largest to date and emphasizes the major impact of clear margins and multidisciplinary management. Neoadjuvant chemotherapy improves disease-free survival and should be recommended for both high and intermediate grade MOS.

Original languageEnglish (US)
Article numbermds507
Pages (from-to)824-831
Number of pages8
JournalAnnals of Oncology
Volume24
Issue number3
DOIs
StatePublished - Mar 1 2013

Keywords

  • Head and neck
  • Jaw
  • Mandible
  • Osteosarcoma
  • Prognostic
  • Treatment

ASJC Scopus subject areas

  • Hematology
  • Oncology

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    Thariat, J., Schouman, T., Brouchet, A., Sarini, J., Miller, R. C., Reychler, H., Ray-Coquard, I., Italiano, A., Verite, C., Sohawon, S., Bompas, E., Dassonville, O., Salas, S., Aldabbagh, K., Maingon, P., de la MotteRouge, T., Kurtz, J. E., Usseglio, J., Kerbrat, P., ... Julieron, M. (2013). Osteosarcomas of the mandible: Multidisciplinary management of a rare tumor of the young adult a cooperative study of the GSF-GETO, rare cancer network, GETTEC/refcor and sfce. Annals of Oncology, 24(3), 824-831. [mds507]. https://doi.org/10.1093/annonc/mds507