Fernandes Rui, Nikitakis Nikolaos G, Pazoki Alexander, Ord Robert A
Division of Maxillofacial Surgery, Department of Surgery, University of Florida College of Medicine, Jacksonville, FL 32209, USA.
J Oral Maxillofac Surg. 2007 Jul;65(7):1286-91. doi: 10.1016/j.joms.2006.10.030.
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%.
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.
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.
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.
所有部位的骨肉瘤（OS）约占原发性恶性骨肿瘤的40%至60%。约10%的骨肉瘤发生于头颈部；多数位于下颌骨或上颌骨。颌骨病变的诊断平均比长骨病变晚20年，长骨病变的发病高峰在10至14岁之间。头颈部骨肉瘤的转移率低于长骨骨肉瘤，其5年生存率较好，在27%至84%之间。
我们介绍了马里兰大学巴尔的摩分校口腔颌面外科在1993年至2003年期间收治的16例颌骨骨肉瘤患者的经验。
通过回顾性病历审查，确定了16例颌骨骨肉瘤病例。患者年龄在14至51岁之间（平均年龄41岁）。性别分布为10名女性和6名男性，比例为1.6:1。对病变部位分布的评估显示，下颌骨的发病频率高于上颌骨（分别为9例和7例）。主要组织学亚型为软骨母细胞型（8例），其次为成骨细胞型（4例）。根据组织学分级，8例肿瘤为高级别，1例为中级，5例为低级别，2例分级不明。总体而言，马里兰大学治疗的14例患者的主要治疗方式均为手术；2例患者选择在其他机构接受治疗。4例高级别骨肉瘤患者接受了以顺铂和阿霉素（盐酸多柔比星；法玛西亚公司，密歇根州卡拉马祖）为主的化疗作为辅助治疗。随访时间为14个月至108个月（平均46个月）。迄今为止，在我们机构接受治疗的14例患者中，12例（86%）在最后一次随访时无疾病证据，2例患者死于该疾病。
鉴于这种疾病的罕见性，本系列代表了颌骨骨肉瘤的一项大型单中心经验。我们的数据显示，与总体已发表报告相比，患者年龄更大，性别分布不同，生存率更高。
