XXXX of the jaws: factors influencing prognosis.

@entity1 @entity146 @entity5 @entity421 @entity89 @entity204
PURPOSE: To evaluate @entity1 , @entity5 , and treatment variables associated with survival in @entity1 with @entity89 ( @entity89 ) and to compare survival in @entity1 treated before 1991 with those managed with more @entity146 treatment protocols since 1992. @entity1 AND METHODS: This is a retrospective cohort study of @entity1 with @entity89 treated at Massachusetts General Hospital from 1967 through 2007. @entity1 were divided by treatment date into Group 1, 1967 to 1991 (n = 30) and Group 2, 1992 to 2009 (n = 17). Medical records were reviewed to collect the following: demographic, radiographic, @entity5 -specific, treatment, and survival data. The 2 subgroups were statistically compared. RESULTS: There were 47 @entity1 (32 males, 15 females) with a mean age of 30.9 years (range 4 to 74). Mandibular location showed a trend toward improved survival (P = .06). Average @entity5 size was 4.38 cm (range 0.5 to 9.0 cm). Larger @entity5 were associated with decreased overall survival (P = .016). Higher grade @entity5 had decreased overall survival (P = .01). Clear surgical margins were obtained in 67% of @entity1 . Clear surgical margins correlated with improved survival (P = .002). Maxillary @entity89 constituted 83% of those with positive margins. Overall, 5-year survival was 68%. Improved 5-year survival was noted in group 2 (77%) compared with group 1 (52%) [P = .0073]. @entity1 who developed secondary @entity421 (n = 10) had 4.5-fold increased risk of @entity204 (P = .01). Recurrence was associated with 7-fold increased risk of @entity204 (P = .0008). Thirteen @entity1 died of @entity89 . CONCLUSIONS: Improved survival was noted in treatment group 2. This group benefited from improved imaging, earlier diagnosis and more @entity146 treatment that included improved surgical clearance. A clear survival advantage for neoadjuvant chemotherapy was not demonstrated.
