TY - JOUR
T1 - Osteosarcomas of the mandible
T2 - Multidisciplinary management of a rare tumor of the young adult a cooperative study of the GSF-GETO, rare cancer network, GETTEC/refcor and sfce
AU - Thariat, J.
AU - Schouman, T.
AU - Brouchet, A.
AU - Sarini, J.
AU - Miller, R. C.
AU - Reychler, H.
AU - Ray-Coquard, I.
AU - Italiano, A.
AU - Verite, C.
AU - Sohawon, S.
AU - Bompas, E.
AU - Dassonville, O.
AU - Salas, S.
AU - Aldabbagh, K.
AU - Maingon, P.
AU - de la MotteRouge, T.
AU - Kurtz, J. E.
AU - Usseglio, J.
AU - Kerbrat, P.
AU - Raoul, G.
AU - Lotz, J. P.
AU - Bar-Sela, G.
AU - Brugières, L.
AU - Chaigneau, L.
AU - Saada, E.
AU - Odin, G.
AU - Marcy, P. Y.
AU - Thyss, A.
AU - Julieron, M.
PY - 2013/3
Y1 - 2013/3
N2 - 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.
AB - 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.
KW - Head and neck
KW - Jaw
KW - Mandible
KW - Osteosarcoma
KW - Prognostic
KW - Treatment
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U2 - 10.1093/annonc/mds507
DO - 10.1093/annonc/mds507
M3 - Article
C2 - 23131392
AN - SCOPUS:84874580869
SN - 0923-7534
VL - 24
SP - 824
EP - 831
JO - Annals of Oncology
JF - Annals of Oncology
IS - 3
ER -