[Dissertations 25 years after the date 13. Sarcomas of the jaws]

On the basis of the dissertation 'Sarcomas of the jaws'from 1982, developments in the imaging and treatment of osteosarcoma in general and of jaws in particular are discussed. The majority of osteosarcomas is found outside the craniofacial skeleton (extracraniofacial). The most frequent primary sites are the distal femur and proximal tibia. Most of these patients are children and adolescents. Only 5% of all osteosarcomas is found within the craniofacial skeleton, especially the jaws. Usually these patients are older. During the past 30 years the treatment of extracraniofacial osteosarcoma has changed from being purely surgical to being surgical in combination with multidrug, multicycle chemotherapy within prospective trials; the 5-year survival rate has risen from 10-20% to 60-70%. For craniofacial osteosarcomas such studies are missing and there is no unanimous opinion about the benefits of chemotherapy. In this group the 5-year survival rate has risen from 25-40% to 60-80%. Factors associated with a good prognosis are tumour size < 4 cm and tumour free resection margins. Developments in imaging have made improvements in preoperative evaluations possible. A plea is made for a prospective study.