Primary intraosseous carcinoma of the jaws

Objectives: To present 8 new cases of primary intraosseous carcinoma of the jaws and to review the literature for an analysis of treatment modalities and patient outcomes. Data Sources: A MEDLINE search from 1970 to 1999. The articles chosen and t he study of the references of every one that produced additional articles p rovided database information for 28 patients. Eight new patients from our i nstitutions were added. Study Selection: Our criteria of inclusion included the absence of ulcerati on of the oral mucosa, a negative result in the search for a distant primar y tumor, and convincing histological documentation. Data Extraction: The variables of the analysis included age, sex, site of t he tumor, condition of the oral mucosa, tumor size, neck status, treatment modalities, recurrences, and survival. Data Synthesis: Twenty-eight patients were identified in the literature, fo r a total of 36 patients. There were 28 males (78%) and 8 females (22%) ran ging in age from 4 to 76 years (mean, 54 years). The tumor site was: the ma ndible in 33 patients (92%) and the maxilla in 3 (8%). Of the 34 patients t reated, 19 (56%) had recurrences. Overall 2- and it-year survival was 60.5% and 39.9%, respectively. Patients who underwent radical surgery and postop erative radiotherapy (n = 11) had a 2- and 3-year survival probability of 6 1.3% and 40.9%, respectively, whereas in the remaining patients (n = 25), t he rates were 59.7% and 31.3%, respectively (P = .60). Conclusions: Strict diagnostic criteria must be applied. The prognosis asso ciated with primary intraosseous carcinoma of the jaws is poor and suggests the need for aggressive treatment.