Management of osteosarcoma of the maxilla and mandible

The treatment protocols of 30 patients with osteosarcoma of the maxilla and mandible presenting to M.D. Anderson Hospital and Tumor Institute over a 30 year period were reviewed. Of the patients who received definitive treatment at this institution, 50 percent of those with maxillary and 71 percent of those with mandibular osteosarcomas survived 5 years. Local recurrences were the major problems, whereas distant metastases occurred less frequently. All patients who died from the cancer did so within 3 years of initial treatment. Primary treatment should consist of aggressive surgical resection. Preoperative radiation therapy is used for mandibular tumors. Postoperative radiation is occasionally used for maxillary cancer. Recurrent disease should be treated by surgery, radiation or chemotherapy as indicated.