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. 2022 Jul 28;17(7):e0268215.
doi: 10.1371/journal.pone.0268215. eCollection 2022.

Chondrosarcoma patient characteristics, management, and outcomes based on over 5,000 cases from the National Cancer Database (NCDB)

Taylor D Ottesen  1   2 , Blake N Shultz  1 , Alana M Munger  1 , Michael Amick  1 , Courtney S Toombs  1 , Gary E Friedaender  1 , Jonathan N Grauer  1
Affiliations

Chondrosarcoma patient characteristics, management, and outcomes based on over 5,000 cases from the National Cancer Database (NCDB)

Taylor D Ottesen et al. PLoS One. .

Abstract

Introduction: Chondrosarcoma, although relatively uncommon, represents a significant percentage of primary osseous tumors. Nonetheless, there are few large-cohort, longitudinal studies of long-term survival and treatment outcomes of chondrosarcoma patients and none using the National Cancer Database (NCDB).

Methods: Chondrosarcoma patients were identified from the 2004-2015 NCDB datasets and divided on three primary tumor sites: appendicular, axial, and other. Demographic, treatment, and long-term survival data were determined for each group. Multivariate Cox analysis and Kaplan-Meier survival curves were generated to assess long-term survival over time for each.

Results: In total, 5,329 chondrosarcoma patients were identified, of which 2,686 were appendicular and 1,616 were axial. Survival was higher among the appendicular cohort than axial at 1-year, 5-year, and 10-year (89.52%, 75.76%, and 65.24%, respectively). Multivariate Cox analysis identified patients in the appendicular cohort to have significantly greater likelihood of death with increasing age category, distant metastases at presentation, and male sex (p<0.001 for each). Best outcomes for seen for those undergoing surgical treatment (p<0.001). Patients in the axial cohort were with increased likelihood of death with increasing age category and distant metastases (p<0.001), while surgical treatment with or without radiation were associated with a significant decrease (p<0.001). Kaplan-Meier survival analysis showed worst survival for the axial cohort (p<0.001) and patients with distant metastases at presentation (p<0.001). Survival was not significantly different between older (2004-2007) and more recent years (2012-2016) (p = 0.742).

Conclusions: For both appendicular and axial chondrosarcomas, surgical treatment remains the mainstay of treatment due to its continued superiority for the long-term survival of patients, although advancements in survival over the last decade have been insignificant. Presence of distant metastases and axial involvement are significant, poor prognostic factors perhaps because of difficulty in surgical excision or extent of disease.

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Conflict of interest statement

One of the authors certifies that he (JNG) or a member of his immediate family, has received or may receive payments or benefits, during the study period, in an amount of USD less than USD 10,000 from TIDI products (Neenah, WI, USA), and in an amount of USD 10,000 to USD 100,000 from the North American Spine Society (Burr Ridge, IL, USA), and is a member of the board of the Lumbar Spine Research Society (Oregon, WI, USA). None of these affiliations are associated with this work and do not pose a conflict of interest in connection with the submitted article. No source of funding. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Long-term survival of patients in the axial, appendicular, and other cohorts (p<0.001).
Fig 2
Fig 2. Long-term survival of all patients with and without distant metastases at the time of presentation (p<0.001).
Fig 3
Fig 3. Long-term survival of patients in the three era groups (p = 0.742).
See this image and copyright information in PMC

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