title: [Jaw osteosarcomas].
abstract: BACKGROUND
  Osteosarcoma (OS) is the most frequent bone malignant tumor. It is usually found on long bones, 5 to 10% are located on jaws, accounting for 0.5 to 1% of all facial tumors. There is little published data which concerns only few patients. Our aim was to study retrospectively cases of facial bone OS in adults, and to compare our results with published data to suggest an optimal management scheme.
  
  
  METHODS
  Thirty-three patients were managed for an OS, from January 1997 to January 2007. Fourteen patients with a maxillary and mandibular OS, treated in first-intention in our unit, were included. The following data were analyzed: age; personal history; circumstance of discovery; clinical, functional, and physical signs; loco-regional extension and metastasis radiological investigation. The histological slides were systematically reviewed. The protocol, therapeutic outcome, and follow-up were studied.
  
  
  RESULTS
  The mean age at diagnosis was 43. Swelling was the most frequent functional sign. The mean delay before management was 3.4 months. The most frequent radiological presentation was a lytic and hyperdense image. The diagnosis was suggested after CT scan in 57.1% of cases. The biopsy was correlated to the anatomopathological analysis in 78.6% of cases. The most common treatment was surgical exeresis completed by chemotherapy. The 5-year survival rate was 50%.
  
  
  CONCLUSIONS
  Jaw OS are specific because of their localization and specific bone ultrastructure. Their management remains controversial: should they be managed like limb OS or treated more specifically? Neoadjuvant chemotherapy, even if it delays exeresis for 3 months, seems to stop the growth or reduce the tumor. An early anatomopathological analysis of the surgical piece determines adjuvant therapy. The negative prognostic factors are: maxillary localization because of limited exeresis margins, tumoral size, and osteoblastic sub-type.
authors.affiliation: Service de stomatologie et chirurgie maxillo-faciale, hôpital de la Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, université Pierre-et-Marie-Curie Paris-6, 47-83 boulevard de l'Hôpital, Paris cedex 13, France.
authors.forename: M
authors.initials: M
authors.lastname: Steve
authors.forename: D
authors.initials: D
authors.lastname: Ernenwein
authors.forename: A
authors.initials: A
authors.lastname: Chaine
authors.forename: C
authors.initials: C
authors.lastname: Bertolus
authors.forename: P
authors.initials: P
authors.lastname: Goudot
authors.forename: B
authors.initials: B
authors.lastname: Ruhin-Poncet
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007573:Jaw Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000706:statistics & numerical data; D012516:Osteosarcoma / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*; D011862:Radiography, Panoramic; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult