Sarcomas of the mandible,

Ivana Petrovic DMD  Zain U. Ahmed  Ashley Hay MBChB, MRCS, DOHNS, FRCS  Evan B. Rosen DMD, MPH  Chuanyong Lu MD  Meera Hameed MD  Jatin P. Shah MD, PhD, DSc, FRCS(Hon)
First published: 16 April 2019 https://doi.org/10.1002/jso.25477
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Abstract
Introduction
Sarcomas of the mandible are extremely rare tumors, with osteosarcoma being the most common, followed by Ewing's sarcoma

Materials and methods
A retrospective review of the clinical records, imaging studies, and pathology slides of patients with sarcoma of the mandible at a Tertiary Care Cancer Center from 1998 to 2014 was undertaken. The impact of neoadjuvant chemotherapy and postoperative radiotherapy with or without chemotherapy was studied, and factors impacting upon local control and disease‐specific survival were analyzed.

Results
Twenty‐two patients were treated over the study period, comprising of 15 males and seven females. External swelling, intraoral growth, or facial numbness were the presenting symptoms. Eighteen patients had osteosarcoma and four had the Ewing's sarcoma. Nine patients received neoadjuvant chemotherapy. All but one patient underwent surgery. Eleven had negative margins, with 90% recurrence‐free survival at 3 years, compared to 10 with positive or close margins, leading to 67% recurrence‐free survival. None of the patients receiving neoadjuvant chemotherapy developed recurrence and all were alive at 3 years. The impact of postoperative radiotherapy or adjuvant chemotherapy was not statistically significant.

Conclusions
Wide surgical resection with negative margins remains the hallmark of surgical treatment.