Survival and prognostic factors in conventional central chondrosarcoma
Abstract Background Chondrosarcoma 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...
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| Format: | Article |
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BMC
2018-08-01
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| Series: | BMC Cancer |
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| Online Access: | http://link.springer.com/article/10.1186/s12885-018-4741-7 |
| _version_ | 1828484768861257728 |
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| author | Julian Fromm Alexander Klein Andrea Baur-Melnyk Thomas Knösel Lars Lindner Christof Birkenmaier Falk Roeder Volkmar Jansson Hans Roland Dürr |
| author_facet | Julian Fromm Alexander Klein Andrea Baur-Melnyk Thomas Knösel Lars Lindner Christof Birkenmaier Falk Roeder Volkmar Jansson Hans Roland Dürr |
| author_sort | Julian Fromm |
| collection | DOAJ |
| description | Abstract Background Chondrosarcoma 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? Methods From 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. Results In 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. Conclusions The 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. |
| first_indexed | 2024-12-11T09:02:44Z |
| format | Article |
| id | doaj.art-10851a76a74a45679585899e836d4ca9 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-11T09:02:44Z |
| publishDate | 2018-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-10851a76a74a45679585899e836d4ca92022-12-22T01:13:43ZengBMCBMC Cancer1471-24072018-08-0118111010.1186/s12885-018-4741-7Survival and prognostic factors in conventional central chondrosarcomaJulian Fromm0Alexander Klein1Andrea Baur-Melnyk2Thomas Knösel3Lars Lindner4Christof Birkenmaier5Falk Roeder6Volkmar Jansson7Hans Roland Dürr8Musculoskeletal Oncology, Department of Orthopedics, Physical Medicine and Rehabilitation, University Hospital, Ludwig-Maximilians-UniversityMusculoskeletal Oncology, Department of Orthopedics, Physical Medicine and Rehabilitation, University Hospital, Ludwig-Maximilians-UniversityDepartment of Radiology, University Hospital, LMU MunichInstitute of Pathology, University Hospital, LMU MunichDepartment of Internal Medicine III (Oncology), University Hospital, LMU MunichMusculoskeletal Oncology, Department of Orthopedics, Physical Medicine and Rehabilitation, University Hospital, Ludwig-Maximilians-UniversityDepartment of Radiotherapy and Radiation Oncology, University Hospital, LMU MunichMusculoskeletal Oncology, Department of Orthopedics, Physical Medicine and Rehabilitation, University Hospital, Ludwig-Maximilians-UniversityMusculoskeletal Oncology, Department of Orthopedics, Physical Medicine and Rehabilitation, University Hospital, Ludwig-Maximilians-UniversityAbstract Background Chondrosarcoma 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? Methods From 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. Results In 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. Conclusions The 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.http://link.springer.com/article/10.1186/s12885-018-4741-7ChondrosarcomaSurgeryMargin statusRecurrencePrognostic factors |
| spellingShingle | Julian Fromm Alexander Klein Andrea Baur-Melnyk Thomas Knösel Lars Lindner Christof Birkenmaier Falk Roeder Volkmar Jansson Hans Roland Dürr Survival and prognostic factors in conventional central chondrosarcoma BMC Cancer Chondrosarcoma Surgery Margin status Recurrence Prognostic factors |
| title | Survival and prognostic factors in conventional central chondrosarcoma |
| title_full | Survival and prognostic factors in conventional central chondrosarcoma |
| title_fullStr | Survival and prognostic factors in conventional central chondrosarcoma |
| title_full_unstemmed | Survival and prognostic factors in conventional central chondrosarcoma |
| title_short | Survival and prognostic factors in conventional central chondrosarcoma |
| title_sort | survival and prognostic factors in conventional central chondrosarcoma |
| topic | Chondrosarcoma Surgery Margin status Recurrence Prognostic factors |
| url | http://link.springer.com/article/10.1186/s12885-018-4741-7 |
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