Oncologic outcome after local recurrence of chondrosarcoma: Analysis of prognostic factors

Kim, Han‐Soo; Bindiganavile, Srimanth; Han, Ilkyu

doi:10.1002/jso.23925

Cited by 26 publications

(24 citation statements)

References 21 publications

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“…This trend is understandable given the aggressive therapies needed to treat such a disease, and has been reported in other sarcomas, and chondrosarcoma in particular. 34 In context, this finding is consistent with children tolerating higher doses of chemotherapy, which is used in instances of advanced disease in mesenchymal and dedifferentiated chondrosarcoma, that may be otherwise intolerable in older patients for therapeutic effect. 18,19,35 Although there was an observed trend, the decade of diagnosis was not found to be associated with a statistically significant improvement in survival in either univariate or multivariate analysis, or for chondrosarcoma variants.…”

Section: Discussionsupporting

confidence: 72%

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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Section: Discussionsupporting

confidence: 72%

Chondrosarcoma of the Osseous Spine

Arshi

Sharim

Park

et al. 2017

Spine

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“…Further subgroup analysis is needed, seeking to find whether this is valid for all CCCS or only the high risk group. Although LR has been linked to increased rates of metastasis and death in CS research, 13,32‐37 this has been performed in mixed CS cohorts and without considering immortal time bias for time dependent variables.…”

Section: Discussionmentioning

confidence: 99%

Risk stratification for central conventional chondrosarcoma of bone: A novel system predicting risk of metastasis and death in the Cancer Registry of Norway cohort

Thorkildsen

Taksdal

Bjerkehagen

et al. 2020

Journal of Surgical Oncology

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Background and Objectives: Interobserver variability in histological grading of central conventional chondrosarcoma (CCCS) limits the quality of patient information and research progression. We aim to quantify known and new prognostic variables and propose a risk stratification model. Method: We selected 149 cases from the Cancer Registry of Norway. Cox proportional hazard models were estimated. Based on these results a dichotomous risk classification was proposed and presented by Kaplan-Meier estimates for rates of local recurrence, metastasis, and disease-specific survival. Results: The influence of axial skeletal location (Hazard ratio [HR] = 19.06), a soft tissue component ≥1 cm (HR = 13.45), and histological grade 3 (HR = 16.46) are all significant in predicting the rate of metastasis. The creation of a variable combining axial skeletal location and a soft tissue component ≥1 cm strongly predicts the risk of metastasis (HR = 14.02; P < .001) and death (HR = 2.74; P = .030) at multivariate analysis, making the histological grade insignificant. Together with metastasis at diagnosis (HR = 285.65; P < .001), this forms the basis of our proposed risk stratification, producing a small highrisk group (39 cases with 33% risk of metastasis) and a large low-risk group (103 cases with 2% risk of metastasis) without a histological grade. Conclusion: Axial skeletal location and a soft tissue component ≥1 cm combined divides a CCCS cohort into low-and high-risk groups without a histological grade.

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“…In this study, ER was defined as developing recurrence within 1 year . During routine follow‐up, patients were monitored in the first month after surgery and once every 3 months afterward during the first year.…”

Section: Methodsmentioning

confidence: 99%

“…1,6 The recurrence rates of pelvic CS range from 17-32% 7 and is associated with poor survival. 8 Previous studies have demonstrated that several risk factors are related to the prognosis of pelvic CS patients; among these factors, grade is the most important one. 2,3,9,10 CS, which is dependent on the presence of cellular atypia, mitotic rate, and cellularity is histologically differentiated into three grades.…”

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confidence: 99%

Can clinical radiomics nomogram based on 3D multiparametric MRI features and clinical characteristics estimate early recurrence of pelvic chondrosarcoma?

Yin

Mao

Liu

et al. 2019

Magnetic Resonance Imaging

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Background Chondrosarcoma (CS) is the second most common primary malignant bone tumor, with a relatively high recurrence rate. However, an effective method that estimates whether pelvic CS will recur after surgery, which influences the formulation of a clinical treatment plan, remains lacking. Purpose To develop and validate a clinical radiomics nomograms based on 3D multiparametric magnetic resonance imaging (mpMRI) features and clinical characteristics that could estimate early recurrence (ER) (≤1 year) of pelvic CS. Study Type Retrospective. Population In all, 103 patients (ER = 41, non‐ER = 62) with histologically proven CS were retrospectively analyzed and divided into a training set (n = 72) and a validation set (n = 31). Field Strength/Sequence 3.0T axial T1‐weighted (T1‐w), T2‐weighted (T2‐w), diffusion weighted imaging (DWI), contrast‐enhanced T1‐weighted (CET1‐w). Assessment Risk factors (sex, age, type, grade, resection margins, etc.) associated with ER were evaluated. Five individual models based on T1‐w, T2‐w, DWI, CET1‐w, and clinical data were built. Then we compared the performance of models based on T1‐w, T2‐w, CET1‐w and their combination. Lastly, two nomograms based on the best model + clinical data and DWI + clinical data were built. Statistical Tests The area under the receiver operating characteristic curve (AUC) and accuracy (ACC) were used to evaluate different models. Results Grade was the most important univariate clinical predictor of ER of pelvic CS patients (odds ratio [OR]1 = 4.616, OR2 = 8.939, P < 0.05). T1‐w + T2‐w + CET1‐w had a significantly higher performance than CET1‐w in the training set (P = 0.01). Radiomics features are more important than clinical characteristics in clinical radiomics nomograms, especially for multisequence combined features (OR = 3.208, P < 0.01). Clinical radiomics nomogram based on combined features (T1‐w + T2‐w + CET1‐w) + clinical data achieved an AUC of 0.891 and ACC of 0.857, followed by DWI + clinical data (AUC = 0.882, ACC = 0.760) in the validation set. Data Conclusion The clinical radiomics nomogram had good performance in estimating ER of pelvic CS patients, which would be helpful in clinical decision‐making. Level of Evidence: 4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:435–445.

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Oncologic outcome after local recurrence of chondrosarcoma: Analysis of prognostic factors

Cited by 26 publications

References 21 publications

Chondrosarcoma of the Osseous Spine

Chondrosarcoma of the Osseous Spine

Risk stratification for central conventional chondrosarcoma of bone: A novel system predicting risk of metastasis and death in the Cancer Registry of Norway cohort

Can clinical radiomics nomogram based on 3D multiparametric MRI features and clinical characteristics estimate early recurrence of pelvic chondrosarcoma?

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