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A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
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Sarcomas of the mandible
Ivana Petrovic1, Zain U Ahmed2, Ashley Hay1
1Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Journal of Surgical Oncology
|April 18, 2019
Summary
Complete surgical resection with negative margins is crucial for treating rare mandibular sarcomas like osteosarcoma and Ewing's sarcoma. Neoadjuvant chemotherapy showed promising results in preventing recurrence and improving survival rates.
Area of Science:
- Oncology
- Surgical Pathology
- Cancer Research
Background:
- Mandibular sarcomas are exceptionally rare malignancies.
- Osteosarcoma is the most frequent type, followed by Ewing's sarcoma.
Purpose of the Study:
- To analyze treatment outcomes for mandibular sarcomas.
- To evaluate the impact of neoadjuvant chemotherapy and adjuvant therapies on local control and survival.
- To identify prognostic factors for mandibular sarcoma patients.
Main Methods:
- Retrospective review of 22 patients diagnosed with mandibular sarcoma between 1998 and 2014.
- Analysis of clinical records, imaging, and pathology.
- Assessment of neoadjuvant chemotherapy, surgery, and postoperative radiotherapy/chemotherapy impact.
Main Results:
- Osteosarcoma (18 patients) and Ewing's sarcoma (4 patients) were identified.
- Negative surgical margins correlated with 90% 3-year recurrence-free survival, versus 67% for positive/close margins.
- Neoadjuvant chemotherapy was associated with no recurrences and 100% 3-year survival; adjuvant treatments showed no statistical significance.
Conclusions:
- Wide surgical resection achieving negative margins is the cornerstone of mandibular sarcoma treatment.
- Neoadjuvant chemotherapy demonstrates significant potential in improving outcomes for these rare tumors.
