Abstract 2504
Background
The most largely used definition (and staging system) of Osteonecrosis of the Jaws (ONJ), more recently named Medication-Releated ONJ (MRONJ), was released by an American Association Oral Maxillofacial Surgery (AAOMS) task force. It is based on clinical features (mainly bone exposure for at least 8 weeks, or – only after 2014 - bone to be probed through a fistula) but the AAOMS is questioned by many experts. A team supported by the Italian Societies of Oral Medicine (SIPMO) and Maxillofacial Surgery (SICMF) suggested adoption of imaging tools (mainly Computed Tomography, CT) together with clinical features (Bedogni et al, Oral Disease 2012) to reach diagnosis (also in suspected cases without bone exposure, so called “Stage 0” according to AAOMS) and to evaluate real disease extension.
Methods
To compare the stage of MRONJ cases at the first observation time in patients receiving antiresorptive therapy (bisphosphonates, denosumab), according to two different staging systems, we reviewed charts and CT scans of cancer and myeloma patients with signs of ONJ.
Results
We collected data of 151 MRONJ patients in two referral centers. Disease: 73 breast cancer; 28 myeloma; 26 prostate cancer; 24 other solid tumors. The AAOMS stage was 0/I/II/III respectively in 34/38/52/27 observed cases. The SIPMO-SICMF stage was I (involvement of only alveolar bone at CT scan)/ II (extended to extralveolar bone) /III (complicated case) respectively in 48/76/27 cases. The 34 AAOMS “stage 0” cases (signs/symptoms without bone exposure) were reclassified as stage I (14) or II (20) or III (0) respectively, according to the Italian staging system.
Conclusions
In cancer and myeloma patients the AAOMS definition and staging system appear inadequate, potentially exposing patients to delayed diagnosis and treatment. The diagnosis and staging should be based not only on clinical data but also on the findings of the maxillofacial region CT scan, since the CT offers larger information about extent and severity of the disease.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5037 - CXCR4, CCR2 and CCR5 expression in subsets of tumor cells with stem and/or EMT features
Presenter: Olga Savelieva
Session: Poster Display session 1
Resources:
Abstract
5729 - Expression of mutant p53 affects cancer cell sensitivity to topotecan
Presenter: Rimma Mingaleeva
Session: Poster Display session 1
Resources:
Abstract
5725 - Breast cancer organoids a new tool for the prediction of drugs penetration and patient’outcome
Presenter: Giuseppina Roscigno
Session: Poster Display session 1
Resources:
Abstract
5680 - Aptamer-mediated exosomes detection for early breast cancer identification.
Presenter: Cristina Quintavalle
Session: Poster Display session 1
Resources:
Abstract
2460 - MicroRNA-181c promotes tamoxifen resistance in breast cancer cells via upregulation Akt/mTOR axis
Presenter: Alexander Scherbakov
Session: Poster Display session 1
Resources:
Abstract
3751 - Spatio-temporal separation of tumor infiltrating CD8+ T-cells and HER2/neu+ tumor cells in tumor-immune milieu of infiltrating ductal carcinoma of the breast
Presenter: Sandhya Sreedharan
Session: Poster Display session 1
Resources:
Abstract
4664 - Large genomic rearrangements in BRCA1 and BRCA2 genes in the Portuguese population.
Presenter: Joao Pinto
Session: Poster Display session 1
Resources:
Abstract
4611 - Non-BRCA1/2 hereditary breast and ovarian cancer: findings from a multidisciplinary program
Presenter: Ana Monteiro
Session: Poster Display session 1
Resources:
Abstract
5340 - Quantitative imaging and characterization of collagen patterns in high grade serous ovarian carcinoma (HGSOC)
Presenter: Ruby Huang
Session: Poster Display session 1
Resources:
Abstract
4209 - Semiquantitative assessment of vimentin expression in prostate cancer (PC)
Presenter: Marina Puchinskaya
Session: Poster Display session 1
Resources:
Abstract