OSTEOGENIC-SARCOMA OF THE JAWS - FACTORS INFLUENCING PROGNOSIS

Thirty cases of osteosarcoma of the jaws were reviewed (20 men and 10 women, mean age 34 years). Seventeen lesions occurred in the mandible and 13 in the maxilla. Swelling without pain was the most common prese nting symptom. Thirteen lesions were initially misdiagnosed as odontog enic infections. Numbness as a presenting symptom was statistically as sociated with poor prognosis. Treatment included all combinations of s urgery, chemotherapy and radiotherapy. Patients receiving chemotherapy with four or more agents showed a trend toward better survival with 7 1% alive and disease-free at the time of review. Patients' increasing age was statistically associated with decreased survival. The average age of survivors was 27 years and nonsurvivors, 40 years. Older patien ts suffered more local recurrences which, in all but one case, resulte d in mortality. Expectedly, clear surgical margins correlated statisti cally with improved survival. With margins of less than 5 mm, 27% of p atients were alive and disease-free as compared to 62% with surgical m argins greater than 5 mm. The importance of early diagnosis, definitiv e surgical treatment and aggressive adjuvant chemotherapy is demonstra ted. The Proportional Hazards Regression model was employed to evaluat e the statistical significance of a variety of factors on disease-free and overall survival.