Prognostic factors in chondrosarcoma of bone.A clinicopathologic analysis with emphasis on histologic grading

Abstract

The relationship between histopathology and tumor behavior was examined in 71 cases of chondrosarcoma. The tumors were grouped into Grades I, 11, and 111 on the basis of mitotic rate, cellularity, and nuclear size. The five-year survival rates of Grades I, 11, and 111 are 90%, 81%, and 43%, respectively, while the corresponding 10-year survival rates are 83%, 64%, and 29%. None of the Grade I chondrosarcomas metastasized, while metastasis was observed with 10% of the Grade I1 tumors and 71% of the Grade 111 tumors. No definite relationship between tumor grade and local recurrence was found. In addition, the significance of the extent of tlie original operative procedure was evaluated for chondrosarcoma, Grades I and 11. Local recurrence which could not be controlled by additional surgery occurred in 46% of the patients treated initially by local excision, but in only 9.5% of those who were treated by amputation or resection of all or part of the involved bone. It is concluded that chondrosarcomas range from locally aggressive non-metastasizing neoplasms to high-grade malignancies with marked metastatic potential, and that these groups may be defined and separated by the use of histopathologic criteria. The rate of local recurrence, however, is primarily dependent on the adequacy of surgical therapy rather than histologic grade.Cancer 40:818-831, 1977.HONDROSARCOMA IS A NEOPLASM WHICH HAS C long been known for the wide variability of its morphology and clinical course. Previous clinicopathologic evaluations of chondrosarcoma have shown that, in general, tumors of higher histologic grade are associated with shorter survival. "," However, the statistical significance of differences in survival rate by histologic grade has not been evaluated in most studies, and consistent correlation between histologic grade and the probability of metastasis has been lacking. This study was undertaken in an effort to

Secondary peripheral chondrosarcoma evolving from osteochondroma as a result of outgrowth of cells with functional EXT

“…For controls, epiphyseal growth plate (n ¼ 2) and articular cartilage (n ¼ 2) were obtained from orthopedic resections for pathological conditions not related to osteochondroma or chondrosarcoma. Chondrosarcoma histological grading was evaluated according to the Evans classification (Evans et al, 1977). Imaging studies (radiography, computed tomographic scans and magnetic resonance imaging scans) were reviewed in all 17 sporadic secondary peripheral chondrosarcomas and in five sporadic osteochondromas.…”

Is Needle Biopsy Clinically Useful in Preoperative Grading of Central Chondrosarcoma of the Pelvis and Long Bones?

“…It is graded on a scale of 1 to 3 according to nuclear size, nuclear staining, and cellularity [3,10,24]. These grading systems correlate well with their clinical behavior [1,10,17], which ranges from slowly growing, rarely metastasizing tumors (Grade 1, now termed atypical cartilaginous tumor/Grade 1 chondrosarcoma to stress that it behaves as a locally aggressive lesion and only metastasizes in exceptional cases) to very aggressive, metastasizing sarcomas (Grade 3). Dedifferentiated chondrosarcoma is defined by the presence of a biphasic tumor composed of a conventional chondrosarcoma (usually Grade 1) and a high-grade, noncartilage-producing sarcoma [3].…”

No improvement in the overall survival of 194 patients with chondrosarcoma in Finland in 1971–1990

“…Only a few studies are available on the prognostic factors in patients with chondrosarcoma (Evans et al 1977, Pritchard et al 1980, Sheth et al 1996, Bjornsson et al 1998, Oshiro et al 1998, Lee et al 1999, Bergh et al 2001. Most of them have been done in specialist treatment centers, which may involve a bias as regards referral of cases.…”