title: Characteristics and prognostic factors of osteosarcoma of the jaws: a retrospective cohort study.
abstract: OBJECTIVE
  Osteosarcoma of the jaws is rare and clinically distinct from osteosarcoma of the long bones of the body with different treatment and outcomes. The literature on these tumors is limited to case reports and small case series mostly from single institutions. We used data from the population-based national Surveillance, Epidemiology and End Results (SEER) cancer registry to determine the epidemiology and prognostic factors associated with osteosarcoma of the jaws.
  
  
  OBJECTIVE
  To investigate the epidemiologic characteristics and prognostic factors for survival in patients diagnosed with osteosarcoma of the jaws.
  
  
  METHODS
  A retrospective, population-based cohort study of 541 patients in the SEER tumor registry diagnosed with osteosarcoma of the jaws from 1973 through 2011 were reviewed.
  
  
  METHODS
  Patients had been treated with surgery, radiation, both, or neither.
  
  
  METHODS
  Overall and disease-specific survival.
  
  
  RESULTS
  A total of 541 patients diagnosed with osteosarcoma of the jaws were identified (49.9% male and 50.1% female, with a mean age of 41.3 years). Kaplan-Meier analysis demonstrated an overall survival (OS) and disease-specific survival (DSS) of 53% and 62%, respectively, at 5 years and 35% and 54%, respectively, at 10 years. Multivariate Cox regression analysis revealed that independent predictors of OS and DSS included age at diagnosis (hazard ratio [HR], 1.03; 95% CI, 1.02-1.04 [P < .001] for OS; and HR, 1.03; 95% CI, 1.02-1.05 [P < .001] for DSS); stage at presentation (HR, 1.37; 95% CI, 1.10-1.71 [P = .006] for OS; and HR, 1.34; 95% CI, 1.01-1.76 [P = .04] for DSS); and surgical resection (HR, 0.31; 95% CI, 0.16-0.60 [P < .001] for OS; and HR, 0.22; 95% CI, 0.09-0.56 [P = .001] for DSS). Tumor size was not significant for OS (HR, 1.00; 95% CI, 1.00-1.01 [P = .11] but significant for DSS (HR, 1.01; 95% CI, 1.00-1.01 [P = .003]).
  
  
  CONCLUSIONS
  To our knowledge, this is the largest study to date investigating prognostic factors for survival in patients diagnosed with osteosarcoma of the jaws. Determinants of survival include age at diagnosis, stage at presentation, tumor size, and surgical therapy. Radiation therapy was not associated with improved survival, reflecting the controversy surrounding its use in clinical literature.
authors: University of California, Los Angeles (UCLA) School of Dentistry, Los Angeles.
authors: Robert J
authors: RJ
authors: Lee
authors: David Geffen School of Medicine at UCLA, Los Angeles, California.
authors: Armin
authors: A
authors: Arshi
authors: Department of Maxillofacial Surgery, Southern California Permanente Medical Group, Los Angeles.
authors: Harry C
authors: HC
authors: Schwartz
authors: Department of Oral & Maxillofacial Pathology, UCLA School of Dentistry, Los Angeles, California.
authors: Russell E
authors: RE
authors: Christensen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007573:Jaw Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012516:Osteosarcoma / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D018426:SEER Program; D015996:Survival Rate; D014481:United States / Q000453:epidemiology