Long-term Outcome of Chondrosarcoma: A Single Institutional Experience

Bindiganavile, Srimanth; Han, Ilkyu; Yun, Ji Yeon; Kim, Han‐Soo

doi:10.4143/crt.2014.135

Cited by 53 publications

(38 citation statements)

References 22 publications

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“…Our results show, that MD is more common in G2/3 lesions as described by others [9, 34, 39, 41] but it is independent from surgical margins with the same rate of MD in R0 and R1 resected patients, and also independent from LR. This is in some respect in contrast to the literature [9, 10, 35] but other authors did see the same, confirming grade and location [42] as risk factors or grade as the only significant risk factor [16] for MD in multivariate analyses. In a large survey in Finland [36] the decade of diagnosis was the only significant factor on MD with an increased risk in the 1980s.…”

Section: Discussionmentioning

confidence: 41%

Survival and prognostic factors in conventional central chondrosarcoma

Fromm¹,

Klein²,

Baur‐Melnyk

et al. 2018

BMC Cancer

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BackgroundChondrosarcoma is the second most frequent primary malignant bone tumor. Treatment is mainly based on surgery. In general, wide resection is advocated at least in G2 and G3 tumors. But which margins should be achieved? Does localization as for example in the pelvis have a higher impact on survival than surgical margins themselves?MethodsFrom 1982 to 2014, 87 consecutive patients were treated by resection. The margin was defined as R0 (wide resection), R1 (marginal resection) or, R2 if the tumor was left intentionally. All patients were followed for evidence of local recurrence or distant metastasis. Overall and recurrence-free survival were calculated, significance analysis was performed.ResultsIn 54 (62%) cases a R0 resection, in 31 (36%) a R1 and in 2 (2%) patients a R2-resection was achieved. Histology proved to be G1 in 37 patients (43%), G2 in 41 (47%) and G3 in 9 cases (10%). 5-year local recurrence-free survival (LRFS) was 75%. Local recurrence-free survival showed a significant association with the margin status and the localization of the tumor with pelvic lesions doing worst. Metastatic disease was initially seen in 4 patients (4.6%), 19 others developed metastatic disease during follow-up. Overall survival of the entire group at 5 and 10 years were 79 and 75%, respectively. The quality of surgical margins and the presence of local recurrence did not influence overall survival in a multivariate analysis. Pelvic lesions had a worse prognosis as did higher grades of the tumor, metastatic disease and age.ConclusionsThe mainstay of therapy in Chondrosarcoma remains surgery. Risk factors as grading, metastatic disease, age and location significantly influence overall survival. Margin status (R0 vs. R1) did influence local recurrence-free survival but not overall survival. Chondrosarcomas of the pelvis have a higher risk of local recurrence and should be treated more aggressively.

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Section: Discussionmentioning

confidence: 41%

Survival and prognostic factors in conventional central chondrosarcoma

Fromm¹,

Klein²,

Baur‐Melnyk

et al. 2018

BMC Cancer

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“…Previous studies have found that high-grade chondrosarcomas of the axial skeleton have significantly worse long-term (at 10 years and beyond) conditional survival compared with high-grade disease of the extremity which further underscores this point. 30,31 …”

Section: Discussionmentioning

confidence: 99%

Chondrosarcoma of the Osseous Spine

Arshi

Sharim

Park

et al. 2017

Spine

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Study Design Retrospective analysis. Objective To determine the epidemiology and prognostic indicators in patients with chondrosarcoma of the osseous spine. Summary of Background Data Chondrosarcoma of the spine is rare, with limited data on its epidemiology, clinicopathologic features, and treatment outcomes. Therapy centers on complete en bloc resection with radiotherapy reserved for subtotal resection or advanced disease. Methods The Surveillance, Epidemiology, and End Results Registry was queried for patients with chondrosarcoma of the osseous spine from 1973 to 2012. Study variables included age, sex, race, year of diagnosis, size, grade, extent of disease, and treatment modality. Results The search identified 973 cases of spinal chondrosarcoma. Mean age at diagnosis was 51.6 years, and 627% of patients were males. Surgical resection and radiotherapy were performed in 75.2% and 21.3% of cases, respectively. Kaplan-Meier analysis demonstrated overall survival (OS) and disease-specific survival (DSS) of 53% and 64%, respectively, at 5 years. Multivariate Cox regression analysis showed that age (OS, P < 0.001; DSS, P = 0.007), grade (OS, P < 0.001; DSS, P < 0.001), surgical resection (OS, P < 0.001; DSS, P < 0.001), and extent of disease (OS, P < 0.001; DSS, P < 0.001) were independent survival determinants; tumor size was an independent predictor of OS (P = 0.006). For confined disease, age (P = 0.013), decade of diagnosis (P = 0.023), and surgery (P = 0.017) were independent determinants of OS. For locally invasive disease, grade (OS, P < 0.001; DSS, P = 0.003), surgery (OS, P = 0.013; DSS, P = 0.046), and size (OS, P = 0.001, DSS, P = 0.002) were independent determinants of OS and DSS. Radiotherapy was an independent indicator of worse OS for both confined (P = 0.004) and locally invasive disease (P = 0.002). For metastatic disease, grade (OS, P = 0.021; DSS, P = 0.012) and surgery (OS, P = 0.007; DSS, P = 0.004) were survival determinants for both OS and DSS, whereas radiotherapy predicted improved OS (P = 0.039). Conclusion Surgical resection confers survival benefit in patients with chondrosarcoma of the spine independent of extent of disease. Radiotherapy improves survival in patients with metastatic disease and worsens outcomes in patients with confined and locally invasive disease.

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“…Although our followup is short, we found no instances of local recurrence in our five patients. Bindiganavile et al [4] stated that the overall survival of chondrosarcoma was 91.6%, 84.1%, and 84.1% at 5, 10, and 15 years, respectively. The high histologic grade and axial location were the two negative outcome predictors.…”

Section: Discussionmentioning

confidence: 99%

Is It Possible and Safe to Perform Acetabular-preserving Resections for Malignant Neoplasms of the Periacetabular Region?

Lam

Yau

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background Primary malignant tumors located near the acetabulum are usually managed by resection of the tumor with wide margins that include the acetabulum. These resections are deemed P2 resections by the Enneking and Dunham classification. There are various methods to perform the subsequent hip reconstruction. Unfortunately, there is no consensus as to the best management. In general, patients undergoing resection at this level will have substantial levels of pain and disability as measured by the Musculoskeletal Tumor Society (MSTS) scoring system. We believe there is a subset of patients whose tumors in this location can be resected while preserving all or most of the weightbearing acetabulum using navigation and careful surgical planning. Questions/purposes (1) What complications were associated with this resection; (2) what oncological outcomes (histological margins and local recurrence) were achieved; and (3) what is the function achieved by these patients? Methods This was a retrospective study of patients with periacetabular primary malignancy. From 2008 to 2014, we treated 12 patients who had periacetabular primary malignant tumors and in five, we performed resection with the weightbearing portion spared. During this period, our general indications to perform a resection that spared the acetabulum were the tumor with its resection margin not involving the weightbearing portion of the acetabulum. However, we did not perform this procedure in patients who had more cranial lesion involving the weightbearing portion or whose hip stability might be in question after the tumor excision. Three patients were women and the other two were men. Four were chondrosarcomas, whereas the other one was synovial sarcoma. Ages ranged from 46 to 60 years (average, 53 years). Minimum followup was 14 months (median, 37 months; range, 14-88 months); no patients were lost to followup before a 1-year minimum was achieved, and all patients have been seen within the last 9 months. Results There were no intraoperative or early postoperative complications. None of the five patients had a positive margin by histological assessment. No local recurrences were detected. The median functional score by MSTS was 28 out of 30 (range, 27-30). Conclusions The roof of the acetabulum is the weightbearing portion of the acetabulum. It also maintains the Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research1 editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed cons...

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Long-term Outcome of Chondrosarcoma: A Single Institutional Experience

Cited by 53 publications

References 22 publications

Survival and prognostic factors in conventional central chondrosarcoma

Survival and prognostic factors in conventional central chondrosarcoma

Chondrosarcoma of the Osseous Spine

Is It Possible and Safe to Perform Acetabular-preserving Resections for Malignant Neoplasms of the Periacetabular Region?

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