Long-term survival of patients with mandibular osteosarcoma

Osteosarcoma generally has a poor prognosis. Osteosarcoma of the mandible is rare and may have a less aggressive course. Three patients with osteosarcoma of the mandible were treated during the past 19 years at National Taiwan University Hospital. All were women, with an average age of 49 years. The patients were treated with radical excision of the tumor, with either pre- or postoperative radiotherapy. None of the patients received chemotherapy. Reconstruction with iliac osteocutaneous free flap, fibular osteoseptocutaneous free flap, or Leibinger reconstruction plate was performed to repair the facial defects resulting from tumor resection or radiation-induced necrosis. The three patients were alive and without evidence of recurrence at the time of writing, with follow-up periods ranging from 7 to 18 years. All had acceptable facial contour and satisfactory oromandibular function after reconstruction. These results support the effectiveness of wide resection with radiotherapy for treatment of mandibular osteosarcoma. With the availability of microsurgical reconstruction and biocompatible reconstruction plates, we advocate extensive ablation of this tumor. Long-term survival, good functional recovery, and acceptable facial contour can be expected.