Primary mandibular tumors, treatment, reconstruction and prognosis
Background. Morphologically both mandibular sarcomas and sarcomas of other origin are very similar, but have difference in there clinical manifestation. Surgery is a gold standard. After partial mandibular resection simultaneous reconstruction is used to improve functional and esthetic aspects. Materials and methods. 82 patients with primary mandibular sarcomas were observed in the Russia Cancer Research Center from I960 till 2008. Osteosarcoma was the most common histological subtype. Surgery alone is the standard of care. Combined chemoradiotherapy is rarely used for specific histological subtypes. Simultaneous reconstruction was made in 23 patients. Reconstructive plate was used in 8 patients. In 3 cases musculo-cutaneous transferred flap was used. Vasculorised bone grafts were transplanted inl5 cases. Results. 5 - year survival in surgery group was 48%. None of patients who received chemoradiotherapy reached 4 year survival checkpoint. Local recurrences were higher when 2 or more anatomic areas where involved. Conclusion. Surgery is still a golden standard of care. Histological subtype, tumor location, surgery technique are the main prognostic factors.