Osteosarcoma of the jaw – experience at the Medical University Vienna and comparative study with international tumor registries

Christina Eder-Czembirek,Doris Moser,Simone Holawe,Thomas Brodowicz,Jutta Ries,Irene Sulzbacher,Edgar Selzer

doi:10.6061/clinics/2019/e701

Christina Eder-Czembirek, Doris Moser + Show 5 more

Open Access

https://doi.org/10.6061/clinics/2019/e701

Copy DOI

Abstract

OBJECTIVES:Osteosarcoma of the jaw (OSAJ) is fundamentally different in clinical practice from its peripheral counterparts. Studies are difficult to conduct due to low incidence rates. The primary aim of this study was to provide for the first time a comprehensive retrospective analysis of the treatment concepts and outcome data of OSAJ patients treated at the University Hospital Vienna and to compare these with two recently published studies on OSAJ. The clinical study was accompanied by a biomarker study investigating the prognostic relevance of melanoma-associated antigen-A (MAGE-A) in OSAJ specimens.METHOD:Eighteen patients were included, and their outcomes were compared to published data. Immunohistochemistry was performed with mouse monoclonal antibodies against MAGE-A. Survival rates were estimated by the Kaplan-Meyer method. The log-rank test was used to analyze potential prognostic parameters. Fisher's exact test was performed to define the significant differences between the survival rates of the current study and the DOESAK registry.RESULTS:Disease-specific survival was 93.8% after five and 56.3% after ten years. The development of metastases (p=0.033) or relapse (p=0.037) was associated with worsened outcomes in our group as well as in the comparative group. Despite the different treatment concepts of the study groups, survival rates were comparable. MAGE-A failed to show prognostic relevance for OSAJ patients.CONCLUSIONS:Uncertainties about the optimal treatment strategies of OSAJ patients will currently remain. Thus, prospective studies of OSAJ are needed but are only feasible in a multicenter study setting, conducted over a prolonged time period.

Highlights

Osteosarcoma (OSA) belongs to the most common primary malignant tumors of the bone, of which approximately 6-7% are primarily localized in the jaw bones (1-3)
We describe for the first time the institutional results of two decades of treatment for OSAJ
We present a retrospectively analyzed group of patients with OSAJs treated at a single institute and compared our data with the two largest published datasets of OSAJs (1,3)

Summary

Introduction

Osteosarcoma (OSA) belongs to the most common primary malignant tumors of the bone, of which approximately 6-7% are primarily localized in the jaw bones (1-3). 5% of OSAs are thought to be secondary malignancies induced by exposure to ionizing irradiation (4-6). The reported incidence of radiation-induced OSAs is approximately 0.8% (5). Comprehensive studies of osteosarcomas of the jaw (OSAJs) are difficult to conduct due to the low incidence (2 cases per 10 million). No potential conflict of interest was reported

Objectives

Methods

Results

Conclusion