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. 2011 Dec;82(6):749-55.
doi: 10.3109/17453674.2011.636668. Epub 2011 Nov 9.

Survival and prognostic factors in chondrosarcoma: results in 115 patients with long-term follow-up

Dimosthenis Andreou  1 , Sebastian Ruppin, Sebastian Fehlberg, Daniel Pink, Mathias Werner, Per-Ulf Tunn
Affiliations

Survival and prognostic factors in chondrosarcoma: results in 115 patients with long-term follow-up

Dimosthenis Andreou et al. Acta Orthop. 2011 Dec.

Abstract

Background and purpose: There have been few long-term studies on the outcome of chondrosarcoma and the findings regarding prognostic factors are controversial. We examined a homogeneous group of patients with primary central chondrosarcoma of bone who were treated according to a uniform surgical protocol at our institution, in order to determine the factors that influence survival and identify potential improvements to our therapeutic algorithm.

Patients and methods: We performed a retrospective analysis of 115 patients with primary central chondrosarcoma of bone who presented with localized disease and who had a minimum follow-up of 5 years after diagnosis. 68 tumors were localized in the extremities and 47 in the axial skeleton or pelvis. 59 patients had a high-grade (II and III) and 56 a low-grade (I) tumor. 94 patients underwent surgical resection with adequate (wide or radical) margins, while 21 patients had inadequate (marginal or intralesional) margins.

Results: Tumor grade and localization were found to be statistically significant independent predictors of disease-related deaths in multivariate analysis. The quality of surgical margins did not influence survival. The AJCC staging system was able to predict prognosis in patients with chondrosarcoma of the extremities, but not in those with tumors of the axial skeleton and pelvis. Long-term survival after secondary metastatic disease was only observed when metastases were resected with wide margins. Patients with metastases who received further treatment with conventional chemotherapy, radiotherapy, and/or further surgery had significantly better survival compared to those who received best supportive care.

Interpretation: The outcome in patients with primary central chondrosarcoma of bone who present with localized disease is mostly affected by tumor-related parameters.

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Figures

Figure 1.
Figure 1.
The impact of tumor location on overall survival.
Figure 2.
Figure 2.
Overall survival (A) and event-free survival (B), according to surgical margins.
Figure 3.
Figure 3.
Overall survival in the entire group (A), the E group (B), and the AP group (C) according to the AJCC staging system.
Figure 4.
Figure 4.
Overall survival following the development of metastatic disease, according to further treatment.
See this image and copyright information in PMC

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