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Clinical significance of adjuvant therapy after radical surgery for primary osteosarcoma of the jaws

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Summary

Background

Osteosarcoma of the jaw is one of the rare malignancies and the role of postoperative adjuvant therapy is unclear. This study explored the efficacy of adjuvant therapy after radical surgery for primary osteosarcoma of the jaw.

Methods

The data were retrospectively analyzed from May 2012 to June 2021. The recurrence rate, disease-free survival (DFS) and 5‑year overall survival (OS) rate were calculated by Kaplan-Meier method. Intergroup rates were examined by chi-square test.

Results

125 post-radical surgery patients were included. The median follow-up time was 66 months. Forty five cases suffered recurrence. The recurrence rate was 36.0%, and the 5‑year OS rate was 68.8%. In the adjuvant treatment group, twenty eight of 99 patients experienced disease progression. In the surgical treatment alone group, seventeen of 26 patients experienced disease progression. The recurrence rates in the two groups were 28.3 and 65.4%, respectively (χ2 = 12.303, p < 0.001). The 5‑year OS rate was 75.8 and 42.3%, respectively (χ2 = 10.734, p = 0.001). The median DFS of the relapse patients was 15.1 months (95% CI:13.00–17.20 months), and the 5‑year OS rate was 40.0%. Among them, 28 patients received adjuvant therapy while 17 received surgical treatment alone. The median DFS was 15.7 and 11.5 months, respectively, p = 0.024. The median OS was 69.6 months (95% CI 55.69 ~ 83.51 months) and 62.4 months (95% CI 49.06 ~ 75.74 months), respectively(p = 0.034).

Conclusion

Adjuvant therapy is one of the effective measures to reduce the relapse rate and improve OS after radical surgery for primary osteosarcoma of the jaw.

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References

  1. Choi JH, Ro JY. The 2020 WHO classification of tumors of bone: an updated review. Adv Anat Pathol. 2021;28(3):119–38. https://doi.org/10.1097/PAP.0000000000000293.

    Article  CAS  PubMed  Google Scholar 

  2. Clark JL, Unni KK, Dahlin DC, et al. Osteosarcoma of the jaw. Cancer. 1983;51(12):2311–6. https://doi.org/10.1002/1097-0142(19830615)51:12〈2311::aid-cncr2820511224〉3.0.co;2‑z. PMID: 6573939.

    Article  CAS  PubMed  Google Scholar 

  3. Granowski-LeCornu M, Chuang SK, Kaban LB, et al. Osteosarcoma of the jaws: factors influencing prognosis. J Oral Maxillofac Surg. 2011;69(9):2368–75. https://doi.org/10.1016/j.joms.2010.10.023.

    Article  PubMed  Google Scholar 

  4. Bennett JH, Thomas G, Evans AW, et al. Osteosarcoma of the jaws: a 30-year retrospective review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;90(3):323–32. https://doi.org/10.1067/moe.2000.108274.

    Article  CAS  PubMed  Google Scholar 

  5. Mardinger O, Givol N, Talmi YP, et al. Osteosarcoma of the jaw. The Chaim Sheba medical center experience. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;91(4):445–51. https://doi.org/10.1067/moe.2001.112330.

    Article  CAS  PubMed  Google Scholar 

  6. Smith RB, Apostolakis LW, Karnell LH, et al. National Cancer Data Base report on osteosarcoma of the head and neck. Cancer. 2003;98(8):1670–80. https://doi.org/10.1002/cncr.11716.

    Article  PubMed  Google Scholar 

  7. Kontio R, Hagström J, Lindholm P, et al. Craniomaxillofacial osteosarcoma—The role of surgical margins. J Craniomaxillofac Surg. 2019;47(6):922–5. https://doi.org/10.1016/j.jcms.2019.03.020.

    Article  CAS  PubMed  Google Scholar 

  8. Ricotta F, Bassi M, Tomasetti N, et al. Osteosarcoma of the jaws: a literature review. Curr Med Imaging. 2021;17(2):225–35. https://doi.org/10.2174/1573405616666200806173948.

    Article  PubMed  Google Scholar 

  9. Patel SG, Meyers P, Huvos AG, et al. Improved outcomes in patients with osteogenic sarcoma of the head and neck. Cancer. 2002;95(7):1495–503. https://doi.org/10.1002/cncr.10849.

    Article  PubMed  Google Scholar 

  10. van Es RJ, Keus RB, van der Waal I, et al. Osteosarcoma of the jaw bones. Long-term follow up of 48 cases. Int J Oral Maxillofac Surg. 1997;26(3):191–7. https://doi.org/10.1016/s0901-5027(97)80818-1.

    Article  PubMed  Google Scholar 

  11. Kämmerer PW, Shabazfar N, Vorkhshori Makoie N, et al. Clinical, therapeutic and prognostic features of osteosarcoma of the jaws—experience of 36 cases. J Craniomaxillofac Surg. 2012;40(6):541–8. https://doi.org/10.1016/j.jcms.2011.10.001.

    Article  PubMed  Google Scholar 

  12. Chindia ML. Osteosarcoma of the jaw bones. Oral Oncol. 2001;37(7):545–7. https://doi.org/10.1016/s1368-8375(00)00129-9.

    Article  CAS  PubMed  Google Scholar 

  13. Eder-Czembirek C, Moser D, Holawe S, et al. Osteosarcoma of the jaw—Experience at the Medical University Vienna and comparative study with international tumor registries. Clinics (Sao Paulo). 2019;74:e701. https://doi.org/10.6061/clinics/2019/e701.

    Article  PubMed  Google Scholar 

  14. Bertin H, Gomez-Brouchet A, Rédini F. Osteosarcoma of the jaws: An overview of the pathophysiological mechanisms. Crit Rev Oncol Hematol. 2020; https://doi.org/10.1016/j.critrevonc.2020.103126.

    Article  PubMed  Google Scholar 

  15. Slootweg PJ, Müller H. Osteosarcoma of the jaw bones. Analysis of 18 cases. J Maxillofac Surg. 1985;13(4):158–66. https://doi.org/10.1016/s0301-0503(85)80040-0.

    Article  CAS  PubMed  Google Scholar 

  16. Delgado R, Maafs E, Alfeiran A, et al. Osteosarcoma of the jaw. Head Neck. 1994;16(3):246–52. https://doi.org/10.1002/hed.2880160307.

    Article  CAS  PubMed  Google Scholar 

  17. Lee RJ, Arshi A, Schwartz HC, et al. Characteristics and prognostic factors of Osteosarcoma of the jaws: A retrospective cohort study. JAMA Otolaryngol Head Neck Surg. 2015;141(5):470–7. https://doi.org/10.1001/jamaoto.2015.0340.

    Article  PubMed  Google Scholar 

  18. Laskar S, Basu A, Muckaden MA, D’Cruz A, Pai S, Jambhekar N, Tike P, Shrivastava SK. Osteosarcoma of the head and neck region: lessons learned from a single-institution experience of 50 patients. Head Neck. 2008;30(8):1020–6. https://doi.org/10.1002/hed.20820.

    Article  PubMed  Google Scholar 

  19. Ferrari D, Codecà C, Battisti N, et al. Multimodality treatment of osteosarcoma of the jaw: a single institution experience. Med Oncol. 2014;31(9):171. https://doi.org/10.1007/s12032-014-0171-9.

    Article  CAS  PubMed  Google Scholar 

  20. Thariat J, Julieron M, Brouchet A, et al. Osteosarcomas of the mandible: are they different from other tumor sites? Crit Rev Oncol Hematol. 2012;82(3):280–95. https://doi.org/10.1016/j.critrevonc.2011.07.001.

    Article  PubMed  Google Scholar 

  21. Tanzawa H, Uchiyama S, Sato K. Statistical observation of osteosarcoma of the maxillofacial region in Japan. Analysis of 114 Japanese cases reported between 1930 and 1989. Oral Surg Oral Med Oral Pathol. 1991;72(4):444–8. https://doi.org/10.1016/0030-4220(91)90558-t.

    Article  CAS  PubMed  Google Scholar 

  22. Guadagnolo BA, Zagars GK, Raymond AK, et al. Osteosarcoma of the jaw/craniofacial region: outcomes after multimodality treatment. Cancer. 2009;115(14):3262–70. https://doi.org/10.1002/cncr.24297.

    Article  PubMed  Google Scholar 

  23. August M, Magennis P, Dewitt D. Osteogenic sarcoma of the jaws: factors influencing prognosis. Int J Oral Maxillofac Surg. 1997;26(3):198–204. https://doi.org/10.1016/s0901-5027(97)80819-3.

    Article  CAS  PubMed  Google Scholar 

  24. Steve M, Ernenwein D, Chaine A, et al. Ostéosarcomes des mâchoires [Jaw osteosarcomas]. Rev Stomatol Chir Maxillofac. 2011;112(5):286–92. https://doi.org/10.1016/j.stomax.2011.08.006.

    Article  CAS  PubMed  Google Scholar 

  25. Thariat J, Schouman T, Brouchet A, et al. Osteosarcomas of the mandible: multidisciplinary management of a rare tumor of the young adult a cooperative study of the GSF-GETO, Rare Cancer Network, GETTEC/REFCOR and SFCE. Ann Oncol. 2013;24(3):824–31. https://doi.org/10.1093/annonc/mds507.

    Article  CAS  PubMed  Google Scholar 

  26. Paparella ML, Olvi LG, Brandizzi D, et al. Osteosarcoma of the jaw: an analysis of a series of 74 cases. Histopathology. 2013;63(4):551–7. https://doi.org/10.1111/his.12191.

    Article  PubMed  Google Scholar 

  27. Yoshida A. Osteosarcoma: old and new challenges. Surg Pathol Clin. 2021;14(4):567–83. https://doi.org/10.1016/j.path.2021.06.003.

    Article  PubMed  Google Scholar 

  28. Chui MH, Kandel RA, Wong M, et al. Histopathologic features of prognostic significance in high-grade osteosarcoma. Arch Pathol Lab Med. 2016;140(11):1231–42. https://doi.org/10.5858/arpa.2015-0389-OA.

    Article  PubMed  Google Scholar 

  29. Padilla RJ, Murrah VA. The spectrum of gnathic osteosarcoma: caveats for the clinician and the pathologist. Head Neck Pathol. 2011;5(1):92–9. https://doi.org/10.1007/s12105-010-0218-y.

    Article  PubMed  Google Scholar 

  30. Laskar S, Kakoti S, Khanna N, et al. Outcomes of osteosarcoma, chondrosarcoma and chordoma treated with image guided-intensity modulated radiation therapy. Radiother Oncol. 2021;164:216–22. https://doi.org/10.1016/j.radonc.2021.09.018.

    Article  PubMed  Google Scholar 

  31. Jingu K, Tsujii H, Mizoe JE, et al. Carbon ion radiation therapy improves the prognosis of unresectable adult bone and soft-tissue sarcoma of the head and neck. Int J Radiat Oncol Biol Phys. 2012;82(5):2125–31. https://doi.org/10.1016/j.ijrobp.2010.08.043.

    Article  PubMed  Google Scholar 

  32. Hug EB, Fitzek MM, Liebsch NJ, et al. Locally challenging osteo- and chondrogenic tumors of the axial skeleton: results of combined proton and photon radiation therapy using three-dimensional treatment planning. Int J Radiat Oncol Biol Phys. 1995;31(3):467–76. https://doi.org/10.1016/0360-3016(94)00390-7.

    Article  CAS  PubMed  Google Scholar 

  33. Ha TW, Park S, Youn MY, et al. Carbon-ion radiotherapy in osteosarcoma of the mandible: a case report. J Korean Assoc Oral Maxillofac Surg. 2021;47(4):315–20. https://doi.org/10.5125/jkaoms.2021.47.4.315.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Huang Q, Hu J, Hu W, et al. Comparison of the efficacy and toxicity of postoperative proton versus carbon ion radiotherapy for head and neck cancers. Ann Transl Med. 2022;10(22):1197. https://doi.org/10.21037/atm-20-5078.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Seidensaal K, Mattke M, Haufe S, et al. The role of combined ion-beam radiotherapy (CIBRT) with protons and carbon ions in a multimodal treatment strategy of inoperable osteosarcoma. Radiother Oncol. 2021;159:8–16. https://doi.org/10.1016/j.radonc.2021.01.029.

    Article  CAS  PubMed  Google Scholar 

  36. Blattmann C, Oertel S, Schulz-Ertner D, et al. Non-randomized therapy trial to determine the safety and efficacy of heavy ion radiotherapy in patients with non-resectable osteosarcoma. BMC Cancer. 2010;10:96. https://doi.org/10.1186/1471-2407-10-96.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Matsunobu A, Imai R, Kamada T, et al. Impact of carbon ion radiotherapy for unresectable osteosarcoma of the trunk. Cancer. 2012;118(18):4555–63. https://doi.org/10.1002/cncr.27451.

    Article  PubMed  Google Scholar 

  38. Ramaekers BL, Pijls-Johannesma M, Joore MA, et al. Systematic review and meta-analysis of radiotherapy in various head and neck cancers: comparing photons, carbon-ions and protons. Cancer Treat Rev. 2011;37(3):185–201. https://doi.org/10.1016/j.ctrv.2010.08.004.

    Article  CAS  PubMed  Google Scholar 

  39. Glanzmann C, Grätz KW. Radionecrosis of the mandibula: a retrospective analysis of the incidence and risk factors. Radiother Oncol. 1995;36(2):94–100. https://doi.org/10.1016/0167-8140(95)01583-3.

    Article  CAS  PubMed  Google Scholar 

  40. Studer G, Grätz KW, Glanzmann C. Osteoradionecrosis of the mandibula in patients treated with different fractionations. Strahlenther Onkol. 2004;180(4):233–40. https://doi.org/10.1007/s00066-004-1171-z.

    Article  PubMed  Google Scholar 

  41. Jereczek-Fossa BA, Orecchia R. Radiotherapy-induced mandibular bone complications. Cancer Treat Rev. 2002;28(1):65–74. https://doi.org/10.1053/ctrv.2002.0254.

    Article  PubMed  Google Scholar 

  42. Sasahara G, Koto M, Ikawa H, et al. Effects of the dose-volume relationship on and risk factors for maxillary osteoradionecrosis after carbon ion radiotherapy. Radiat Oncol. 2014;9(1):92. https://doi.org/10.1186/1748-717X-9-92.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Medical Oncology, Fengxian District Central Hospital, 201499, Shanghai, China

    Shenghong Wu, Jinfeng Zhang & Zhonghui He

  2. Department of Oncology, Huashan Hospital, Fudan University, 200040, Shanghai, China

    Yu Wang

  3. Department of Medical Oncology, Sixth People’s Hospital, Shanghai Jiao Tong University, 201306, Shanghai, China

    Yuanjue Sun

  4. Department of Radiotherapy, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No.160 Pujian Road, 200127, Shanghai, China

    Ming Ye

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  4. Zhonghui He
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Contributions

S. Wu and Y. Wang: designed the experiments; J. Zhang and Z. He: performed the experiments. Y. Sun and M. Ye: collected and analyzed the data, drafted manuscript. All authors read and approved the final manuscript.

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Correspondence to Ming Ye.

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Conflict of interest

S. Wu, Y. Wang, J. Zhang, Z. He, Y. Sun and M. Ye declare that they have no competing interests.

Ethical standards

All procedures performed in studies involving human participants or on human tissue were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Ethics Committee of the Sixth People’s Hospital of Shanghai Jiaotong University, Shanghai Fengxian District Central Hospital, Huashan Hospital of Fudan University, and Renji Hospital of Shanghai Jiaotong University School of Medicine. Informed consent was obtained from all individual participants included in the study.

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The authors S. Wu and Y. Wang contributed equally to this work.

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The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Wu, S., Wang, Y., Zhang, J. et al. Clinical significance of adjuvant therapy after radical surgery for primary osteosarcoma of the jaws. Wien Klin Wochenschr 135, 488–495 (2023). https://doi.org/10.1007/s00508-023-02228-x

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