A review of the behaviour of chondrosarcoma of bone

Abstract

Sixty-two cases of chondrosarcoma of bone were reviewed and histologically graded as low, medium or high-grade tumours. After excluding patients dead from unrelated causes or lost to follow-up, forty cases were available for ten-year follow-up and fifty-eight for five-year follow-up. The rates of survival, recurrence and metastasis were analysed according to the histological grading. Recurrence was further analysed according to the adequacy of treatment. The results were compared with those previously reported in the literature. There was a ten-year survival rate of 58 per cent. Recurrence developed in 58 per cent and was uncontrollable in 29 per cent. The recurrence rate was 87 per cent with inadequate treatment and 15 per cent with adequate treatment. Recurrences outside the limb bones usually proved uncontrollable; recurrences in the limb bones were amenable to further, and if necessary repeated, operations. High-grade chondrosarcoma had a metastatic risk of 75 per cent and eventual mortality of 88 per cent. Medium-grade chondrosarcoma had a metastatic risk of 14 per cent and a mortality of 60 per cent. Low-grade chondrosarcoma had a metastatic risk of 5 per cent and a mortality of 29 per cent.

Curettage and Cryosurgery for Low-grade Cartilage Tumors Is Associated with Low Recurrence and High Function

“…Also, of the 39 patients who returned to the clinic for followup, seven did not have MSTS functional scores. Fourth, a median followup of 18 months, although adequate to detect local recurrence, as in the patient described in this study, is not sufficient to identify late recurrence known to occur in low-grade tumors [26]. However, eight patients were followed for longer than 5 years without any evidence of recurrence (Table 1).…”

“…The mean, median, and mode MSTS functional scores of the 39 subjects from whom MSTS scores were obtained were 27.2, 29, and 30, respectively, of 30 points (Fig. 3) (SD 4.8; range, [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30].…”

“…Because the true malignant potential of these tumors on initial diagnosis is uncertain, the risks and morbidity of such aggressive extralesional surgery may be unnecessarily excessive, especially for patients with enchondromas. In addition, Grade 1 chondrosarcomas are slow-growing and have an inherently low rate of metastasis [15,26]. To determine whether patients may benefit from an intralesional, bone-preserving procedure such as curettage with adjuvant cryosurgery, we retrospectively evaluated the recurrence rates and functional scores of patients with Grade 1 chondrosarcomas or enchondromas treated by this procedure.…”

“…In contrast, enchondromas have a very low incidence of recurrence and do not metastasize [19], and often are found at distal locations such as the hands and feet [7,12]. Two large series suggest that despite their ability to metastasize, Grade 1 chondrosarcomas are slow-growing and have a low rate of metastasis [15,26]. Currently, surgery is the only effective treatment for chondrosarcomas because these tumors are resistant to chemotherapy and radiotherapy [7,19,28].…”

Low-grade chondrosarcoma of bone: experiences from the Vienna Bone and Soft Tissue Tumour Registry

“…The majority of these reports were limited to long bone lesions and did not reflect data concerning truncal LCS. Since local recurrence in a truncal location is more related to the adequacy of surgical margins than to grading, the literature reflects the acceptance of this principle as the only treatment factor that potentially can be controlled or influenced by the surgeon [10,[20][21][22]. Moreover, in contrast to extremity lesions, where local recurrence can be treated by wide excision after intralesional treatment [23], local recurrence in the trunk is technically difficult to treat and is associated with a higher complication rate [7].…”