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Primary Intraosseous Carcinoma of the Jaws
Narcisse Zwetyenga, MD;
Jacques Pinsolle, MD;
Janine Rivel, MD;
Claire Majoufre-Lefebvre, MD;
Alain Faucher, MD;
Vincent Pinsolle, MD
Arch Otolaryngol Head Neck Surg. 2001;127:794-797.
Objectives To present 8 new cases of primary intraosseous carcinoma of the jaws
and to review the literature for an analysis of treatment modalities and patient
outcomes.
Data Sources A MEDLINE search from 1970 to 1999. The articles chosen and the study
of the references of every one that produced additional articles provided
database information for 28 patients. Eight new patients from our institutions
were added.
Study Selection Our criteria of inclusion included the absence of ulceration of the
oral mucosa, a negative result in the search for a distant primary tumor,
and convincing histological documentation.
Data Extraction The variables of the analysis included age, sex, site of the tumor,
condition of the oral mucosa, tumor size, neck status, treatment modalities,
recurrences, and survival.
Data Synthesis Twenty-eight patients were identified in the literature, for a total
of 36 patients. There were 28 males (78%) and 8 females (22%) ranging in age
from 4 to 76 years (mean, 54 years). The tumor site was the mandible in 33
patients (92%) and the maxilla in 3 (8%). Of the 34 patients treated, 19 (56%)
had recurrences. Overall 2- and 4-year survival was 60.5% and 39.9%, respectively.
Patients who underwent radical surgery and postoperative radiotherapy (n =
11) had a 2- and 3-year survival probability of 61.3% and 40.9%, respectively,
whereas in the remaining patients (n = 25), the rates were 59.7% and 31.3%,
respectively (P = .60).
Conclusions Strict diagnostic criteria must be applied. The prognosis associated
with primary intraosseous carcinoma of the jaws is poor and suggests the need
for aggressive treatment.
From the Departments of Maxillofacial and Plastic Surgery (Drs Zwetyenga,
J. Pinsolle, and Majoufre-Lefebvre) and Pathology (Dr Rivel), Centre Hospitalier
Universitaire de Bordeaux, and the Department of Surgery, Institut Bergonié
(Drs Faucher and V. Pinsolle), Bordeaux, France.
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