A1 Refereed original research article in a scientific journal

Craniomaxillofacial osteosarcoma - The role of surgical margins




AuthorsR. Kontio, J. Hagström, P. Lindholm, T. Böhling, M. Sampo, K. Mesimäki, K. Saarilahti, P. Koivunen, A.A. Mäkitie

PublisherCHURCHILL LIVINGSTONE

Publication year2019

JournalJournal of Cranio-Maxillofacial Surgery

Journal name in sourceJOURNAL OF CRANIO-MAXILLOFACIAL SURGERY

Journal acronymJ CRANIO MAXILL SURG

Volume47

Issue6

First page 922

Last page925

Number of pages4

ISSN1010-5182

DOIhttps://doi.org/10.1016/j.jcms.2019.03.020


Abstract
Background: Osteosarcomas (OS) in the craniomaxillofacial (CMF) region are typically diagnosed at later age than long-bone OS, but they are reported to have better 5-year survival. Curative treatment warrants wide surgical resection, which is often not possible in the CMF region. The purpose of this article is to present a nationwide series of CMF in Finland to discuss the role of surgery.
Patients and methods: All 21 CMF OS patients managed in Finland from 1992 to 2009 were included. The mean age was 40 years (range 15e72). Data on patient and tumor characteristics, treatment modalities, and survival were recorded. All patients had a minimum follow-up of 5 years or until death.
Results: OS was evenly represented in the mandible and maxillary bones, which together constituted 76% of all sites. Surgery with curative intent was carried out in 20 patients. Clear margins were achieved in only five cases. Eight (40%) of these 20 patients died due to OS, and their average survival time was 1.3 years. Seven (35%) out of the 20 patients received radiotherapy due to close/intralesional surgical margins, and four of them did not develop recurrences during the follow-up.
Conclusions: The results suggest that postoperative radiotherapy may alter the prognosis in CMF OS, particularly in cases with close or intralesional margins. This may increase the survival rates achieved by prompt action in performing radical surgery. (C) 2019 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.



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