Petrovic Ivana, Ahmed Zain U, Hay Ashley, Rosen Evan B, Lu Chuanyong, Hameed Meera, Shah Jatin P
Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Department of Surgery, Dental Service, Memorial Sloan Kettering Cancer Center, New York, New York.
J Surg Oncol. 2019 Aug;120(2):109-116. doi: 10.1002/jso.25477. Epub 2019 Apr 16.
Sarcomas of the mandible are extremely rare tumors, with osteosarcoma being the most common, followed by Ewing's sarcoma MATERIALS AND METHODS: A retrospective review of the clinical records, imaging studies, and pathology slides of patients with sarcoma of the mandible at a Tertiary Care Cancer Center from 1998 to 2014 was undertaken. The impact of neoadjuvant chemotherapy and postoperative radiotherapy with or without chemotherapy was studied, and factors impacting upon local control and disease-specific survival were analyzed.
Twenty-two patients were treated over the study period, comprising of 15 males and seven females. External swelling, intraoral growth, or facial numbness were the presenting symptoms. Eighteen patients had osteosarcoma and four had the Ewing's sarcoma. Nine patients received neoadjuvant chemotherapy. All but one patient underwent surgery. Eleven had negative margins, with 90% recurrence-free survival at 3 years, compared to 10 with positive or close margins, leading to 67% recurrence-free survival. None of the patients receiving neoadjuvant chemotherapy developed recurrence and all were alive at 3 years. The impact of postoperative radiotherapy or adjuvant chemotherapy was not statistically significant.
Wide surgical resection with negative margins remains the hallmark of surgical treatment.
下颌骨肉瘤是极为罕见的肿瘤,其中骨肉瘤最为常见,其次是尤因肉瘤。
对一家三级癌症中心1998年至2014年期间下颌骨肉瘤患者的临床记录、影像学研究和病理切片进行回顾性分析。研究了新辅助化疗以及术后放疗(无论是否联合化疗)的影响,并分析了影响局部控制和疾病特异性生存的因素。
在研究期间共治疗了22例患者,其中男性15例,女性7例。主要症状为外部肿胀、口腔内肿物或面部麻木。18例患者患有骨肉瘤,4例患有尤因肉瘤。9例患者接受了新辅助化疗。除1例患者外,其余均接受了手术。11例患者切缘阴性,3年无复发生存率为90%,而10例切缘阳性或接近阳性的患者,3年无复发生存率为67%。接受新辅助化疗的患者均未复发,3年时全部存活。术后放疗或辅助化疗的影响无统计学意义。
切缘阴性的广泛手术切除仍然是外科治疗的关键。