Dedifferentiated chondrosarcoma?a fatal disease

Bruns, J.; Fiedler, Walter; Werner, Michael; Delling, G.

doi:10.1007/s00432-004-0648-6

Cited by 50 publications

(59 citation statements)

References 31 publications

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“…3,5,14 Management often includes aggressive en bloc resection to obtain local oncological control with concomitant instrumented fixation to stabilize the lumbopelvic junction and pelvic ring. [1][2][3][4]6,17,21 Such resections are associated with a high level of postoperative complications, including neurological dysfunction, visceral or vascular injury, and SSI. 11 The latter complication may be substantially higher for sacral lesions when compared with other areas of the spine, probably due to the proximity of surgical exposure to the rectum and the substantial soft-tissue resection often required for radical resections.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of factors associated with postoperative infection following sacral tumor resection

Sciubba

Nelson

Gok

et al. 2008

SPI

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Object Resection of sacral tumors has been shown to improve survival, since the oncological prognosis is commonly correlated with the extent of local tumor control. However, extensive soft-tissue resection in close proximity to the rectum may predispose patients to wound complications and infection. To identify potential risk factors, a review of clinical outcomes for sacral tumor resections over the past 5 years at a single institution was completed, paying special attention to procedure-related complications. Methods Between 2002 and 2007, 46 patients with sacral tumors were treated with surgery. Demographic data, details of surgery, type of tumor, and patient characteristics associated with surgical site infections (SSIs) were collected; these data included presence of the following variables: diabetes, obesity, smoking, steroid use, previous surgery, previous radiation, cerebrospinal fluid leak, number of spinal levels exposed, instrumentation, number of surgeons scrubbed in to the procedure, serum albumin level, and combined anterior-posterior approach. Logistic regression analysis was implemented to find an association of such variables with the presence of SSI. Results A total of 46 patients were treated for sacral tumor resections; 20 were male (43%) and 26 were female (57%), with an average age of 46 years (range 11–83 years). Histopathological findings included the following: chordoma in 19 (41%), ependymoma in 5 (11%), rectal adenocarcinoma in 5 (11%), giant cell tumor in 4 (9%), and other in 13 (28%). There were 18 cases of wound infection (39%), and 2 cases of repeat surgery for tumor recurrence (1 chordoma and 1 giant cell tumor). Factors associated with increased likelihood of infection included previous lumbosacral surgery (p = 0.0184; odds ratio [OR] 7.955) and number of surgeons scrubbed in to the operation (p = 0.0332; OR 4.018). Increasing age (p = 0.0864; OR 1.031), presence of complex soft-tissue reconstruction (p = 0.118; OR 3.789), and bowel and bladder dysfunction (p = 0.119; OR 2.667) demonstrated a trend toward increased risk of SSI. Conclusions Patients undergoing sacral tumor surgery may be at greater risk for developing wound complications due to the extensive soft-tissue resections often required, especially with the increased potential for contamination from the neighboring rectum. In this study, it appears that previous lumbosacral surgery, number of surgeons scrubbed in, patient age, bowel and bladder dysfunction, and complex tissue reconstruction may predict those patients more prone to developing postoperative SSIs.

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Section: Discussionmentioning

confidence: 99%

Evaluation of factors associated with postoperative infection following sacral tumor resection

Sciubba

Nelson

Gok

et al. 2008

SPI

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“…Ifosfamide [14] or methotrexate [10] incorporated into the standard regimen has been reported in a small number of patients with DDC [11]. Despite aggressive therapy, the reported 2-year survival rate remains less than 20% [10].…”

Section: Introductionmentioning

confidence: 99%

“…of cases demonstrating good histological response (considered more than 90% necrosis) [6,10,11], and improvement in outcome with adjuvant chemotherapy [6] in DDC. However, these studies have omitted any specific analysis of those with osteosarcomatous differentiation.…”

Section: Introductionmentioning

confidence: 99%

Dedifferentiated Chondrosarcoma Demonstrating Osteosarcomatous Differentiation

et al. 2018

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Background: Dedifferentiated chondrosarcoma (DDC) accounts for a small proportion of chondrosarcomas. They demonstrate aggressive behaviour with a high rate of local recurrence and systemic progression resulting in poor long-term survival rates. Due to its relatively low incidence, previous studies have grouped different histiotypes together to achieve adequate study numbers for analysis. Methods: This retrospective study examines the clinical course and the role of chemotherapy in the subgroup of patients with DDC where osteosarcoma is the predominant dedifferentiated component. Between 2000-2010, 21 patients were identified. Results: The mean age at presentation was 64 years (range 35-80 years). 12 patients were considered unfit for chemotherapy, whilst 2 patients declined chemotherapy. 5 patients received neoadjuvant chemotherapy, with less than 90% necrosis demonstrated in all these cases. 3 patients received post-operative chemotherapy. The median survival for the entire group was 9.5 months. In the 7 patients who received chemotherapy, the median survival was 17 months, and those who had chemotherapy had a greater median time to local recurrence. Conclusion: This study demonstrates that cytotoxic chemotherapy may be offered to appropriately selected patients.

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“…Despite adequate, aggressive, initial, wide surgical resection or even amputation, unfortunately, metastases occur early and frequently and commonly involve the lungs, lymph nodes, and viscera (5)(6)(7)(8)(9)(10)(11)(12). It is the poorly differentiated component that metastasizes.…”

Section: Introductionmentioning

confidence: 99%

“…It is the poorly differentiated component that metastasizes. The prognosis is dismal, with an estimated 5-year survival rate of <10-25% (5)(6)(7)(8)(9)(10)(11)(12). Many analyses of dedifferentiated CS are available at the clinico-pathological level, and the cell biology of this neoplasm is still not clearly understood.…”

Section: Introductionmentioning

confidence: 99%

A novel mutated cell line with characteristics of dedifferentiated chondrosarcoma

Yang

Chen²,

Zhang³

et al. 2009

Int J Mol Med

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Abstract. Dedifferentiated chondrosarcoma (CS) is a rare, highly malignant variant of CS in which a high-grade sarcoma coexists with a low-grade chondroid tumor. In this study, a novel dedifferentiated CS cell line, MS0812, was spontaneously established from mutated human embryonic muscle cells. Several features of the cell line were investigated, including growth characteristics, cytogenetics, electron microscopic features, expression of various antigenic markers and tumor formation. MS0812 has been cultured continuously for more than 3 years. The growth characteristics of MS0812 are similar to the immortalized cell lines as reported. The cell line exhibited complex karyotypes and hyperploidy, the chromosome number ranged from 50 to 158. MS0812 was positive for vimentin, desmin and muscle actin, indicating their muscle origin. With specific inductive condition, MS0812 differentiates into neural cells and adipocytes. Deletion of the p16 gene, which seemed to play a major role in the malignant phenotype of this cell line, was confirmed by PCR and immunocytochemistry. MS0812 formed tumors in nude mice, and the tumor revealed a fibrosarcoma with chondroid components, which were consistent with dedifferentiated CS as reported. Chondroid components showed metachromasia by Alcian blue and toluidine blue and were S100 and collagen-II positive. To our knowledge, this is the first report of the establishment of a human dedifferentiated chondrosarcoma from mutated human embryonic muscle cells, and it is a useful model for the study of the molecular pathogenesis of dedifferentiated CS. IntroductionChondrosarcoma (CS) is the second most frequent primary malignant bone tumor after osteosarcoma and is characterized by basic neoplastic histology with cartilaginous stroma. The most frequent locations are the femur, pelvis and humerus, and 62% of patients are in the fourth, fifth and sixth decades of life (1-4). About 10% of CS undergoes regional anaplastic change, resulting in a high-grade noncartilaginous sarcoma arising within a typically low-grade CS, known as dedifferentiated CS (1-4), this concept was first introduced by Dahlin and Beabout in 1971 (5). They reported 33 cases of well-differentiated CS of bone with additional malignant mesenchymal components, such as fibrosarcoma or osteosarcoma. Some authors prefer instead to use the term CS with additional malignant mesenchymal component because of the morphogenesis of the tumor (5).Dedifferentiated CS is a highly lethal malignancy. Despite adequate, aggressive, initial, wide surgical resection or even amputation, unfortunately, metastases occur early and frequently and commonly involve the lungs, lymph nodes, and viscera (5-12). It is the poorly differentiated component that metastasizes. The prognosis is dismal, with an estimated 5-year survival rate of <10-25% (5-12). Many analyses of dedifferentiated CS are available at the clinico-pathological level, and the cell biology of this neoplasm is still not clearly understood. To our knowledge, there is only one report descr...

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Dedifferentiated chondrosarcoma?a fatal disease

Cited by 50 publications

References 31 publications

Evaluation of factors associated with postoperative infection following sacral tumor resection

Evaluation of factors associated with postoperative infection following sacral tumor resection

Dedifferentiated Chondrosarcoma Demonstrating Osteosarcomatous Differentiation

A novel mutated cell line with characteristics of dedifferentiated chondrosarcoma

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