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Chondrosarcoma of the Pelvis

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Surgery of Pelvic Bone Tumors

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Abstract

Chondrosarcoma (CS) is a malignant cartilaginous matrix-producing tumor that appears mainly in adults in the age range between 50 and 70 years and only seldom in children and young adults. Accounting for 20% of all primary bone malignancies, it appears to be the most common bone sarcoma in the pelvis. One quarter of all CS occur in the pelvis and because of an existing chemo- and radioresistance and lack of efficient adjuvant therapies, limb-salvage surgery is the mainstay in treatment of pelvic CS nowadays. This fact emphasizes the importance of the achievement of wide margins, especially in CS. Since there is no survival benefit of ablative surgery, a battery of different limb-salvage surgical procedures with and without reconstruction of the pelvic ring evolved and were described in small, medium, and large case series. These include hip transposition, arthrodesis, pseudoarthrosis, reconstructions by use of massive pelvic allograft, composite allografts or custom-made pelvic megaprostheses as well as special endoprosthetic devices of periacetabular tumors like the saddle prosthesis or stemmed acetabular pedestal cups. On the basis of these case series of pelvic reconstruction, surgeons can adapt best surgical solutions to individual tumor-diseases with awareness of specific possible oncologic and functional success as well as failure rates.

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References

  1. van Praag Veroniek VM, Rueten-Budde AJ, Ho V, Dijkstra PDS, Study group Bone and Soft tissue tumours (WeBot), Fiocco M, et al. Incidence, outcomes and prognostic factors during 25 years of treatment of chondrosarcomas. Surg Oncol. 2018;27(3):402–8.

    Article  PubMed  Google Scholar 

  2. Giuffrida AY, Burgueno JE, Koniaris LG, Gutierrez JC, Duncan R, Scully SP. Chondrosarcoma in the United States (1973 to 2003): an analysis of 2890 cases from the SEER database. J Bone Joint Surg Am. 2009;91(5):1063–72.

    Article  PubMed  Google Scholar 

  3. Picci P, Manfrini M, Fabbri N, Gambarotti M, Vanel D, editors. Atlas of musculoskeletal tumors and tumorlike lesions: the Rizzoli case archive [Internet]. Cham: Springer International Publishing; 2014. [cited 2019 Aug 10]. Available from: https://www.springer.com/de/book/9783319017471

    Google Scholar 

  4. Stihsen C, Panotopoulos J, Puchner SE, Sevelda F, Kaider A, Windhager R, et al. The outcome of the surgical treatment of pelvic chondrosarcomas: a competing risk analysis of 58 tumours from a single centre. Bone Joint J. 2017;99-B(5):686–96.

    Article  CAS  PubMed  Google Scholar 

  5. Aprin H, Riseborough EJ, Hall JE. Chondrosarcoma in children and adolescents. Clin Orthop Relat Res. 1982;166:226–32.

    Google Scholar 

  6. Guo W, Li D, Tang X, Ji T. Surgical treatment of pelvic chondrosarcoma involving periacetabulum. J Surg Oncol. 2010;101(2):160–5.

    Article  PubMed  Google Scholar 

  7. Karpik M, Reszeć J. Low grade chondrosarcoma - epidemiology, diagnosis, treatment. Ortop Traumatol Rehabil. 2018;20(1):65–70.

    Article  PubMed  Google Scholar 

  8. Olivieri V, Fortunati V, Annoscia S, Massarelli M, Bellei L, Ollino M, et al. Advanced chondrosarcoma of the pelvis: a rare case of urinary obstruction. Arch Ital Urol Androl. 2019;90(4):293–4.

    Article  PubMed  Google Scholar 

  9. Frassica FJ, Chao EY, Sim FH. Special problems in limb-salvage surgery. Semin Surg Oncol. 1997;13(1):55–63.

    Article  CAS  PubMed  Google Scholar 

  10. Deloin X, Dumaine V, Biau D, Karoubi M, Babinet A, Tomeno B, et al. Pelvic chondrosarcomas: surgical treatment options. Orthop Traumatol Surg Res. 2009;95(6):393–401.

    Article  CAS  PubMed  Google Scholar 

  11. Roitman PD, Farfalli GL, Ayerza MA, Múscolo DL, Milano FE, Aponte-Tinao LA. Is needle biopsy clinically useful in preoperative grading of central chondrosarcoma of the pelvis and long bones? Clin Orthop Relat Res. 2017;475(3):808–14.

    Article  PubMed  Google Scholar 

  12. Stevenson JD, Laitinen MK, Parry MC, Sumathi V, Grimer RJ, Jeys LM. The role of surgical margins in chondrosarcoma. Eur J Surg Oncol. 2018;44(9):1412–8.

    Article  PubMed  Google Scholar 

  13. Murphey MD, Walker EA, Wilson AJ, Kransdorf MJ, Temple HT, Gannon FH. From the archives of the AFIP: imaging of primary chondrosarcoma: radiologic-pathologic correlation. Radiographics. 2003;23(5):1245–78.

    Article  PubMed  Google Scholar 

  14. Brenner W, Conrad EU, Eary JF. FDG PET imaging for grading and prediction of outcome in chondrosarcoma patients. Eur J Nucl Med Mol Imaging. 2004;31(2):189–95.

    Article  PubMed  Google Scholar 

  15. Jeys L, Matharu GS, Nandra RS, Grimer RJ. Can computer navigation-assisted surgery reduce the risk of an intralesional margin and reduce the rate of local recurrence in patients with a tumour of the pelvis or sacrum? Bone Joint J. 2013;95-B(10):1417–24.

    Article  CAS  PubMed  Google Scholar 

  16. Gerbers JG, Jutte PC. Hip-sparing approach using computer navigation in periacetabular chondrosarcoma. Comput Aided Surg. 2013;18(1–2):27–32.

    Article  CAS  PubMed  Google Scholar 

  17. Bus MPA, Campanacci DA, Albergo JI, Leithner A, van de Sande MAJ, Gaston CL, et al. Conventional primary central chondrosarcoma of the pelvis: prognostic factors and outcome of surgical treatment in 162 patients. J Bone Joint Surg Am. 2018;100(4):316–25.

    Article  PubMed  Google Scholar 

  18. Mavrogenis AF, Angelini A, Drago G, Merlino B, Ruggieri P. Survival analysis of patients with chondrosarcomas of the pelvis. J Surg Oncol. 2013;108(1):19–27.

    Article  PubMed  Google Scholar 

  19. Pring ME, Weber KL, Unni KK, Sim FH. Chondrosarcoma of the pelvis. A review of sixty-four cases. J Bone Joint Surg Am. 2001;83(11):1630–42.

    Article  CAS  PubMed  Google Scholar 

  20. Wirbel RJ, Schulte M, Maier B, Koschnik M, Mutschler WE. Chondrosarcoma of the pelvis: oncologic and functional outcome. Sarcoma. 2000;4(4):161–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Kim C-Y, Collier CD, Liu RW, Getty PJ. Are limb-sparing surgical resections comparable to amputation for patients with pelvic chondrosarcoma? A case-control, propensity score-matched analysis of the National Cancer Database. Clin Orthop Relat Res. 2019;477(3):596–605.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Enneking WF, Dunham WK. Resection and reconstruction for primary neoplasms involving the innominate bone. J Bone Joint Surg Am. 1978;60(6):731–46.

    Article  CAS  PubMed  Google Scholar 

  23. Beadel GP, McLaughlin CE, Aljassir F, Turcotte RE, Isler MH, Ferguson P, et al. Iliosacral resection for primary bone tumors: is pelvic reconstruction necessary? Clin Orthop Relat Res. 2005;438:22–9.

    Article  PubMed  Google Scholar 

  24. Ozaki T, Hillmann A, Bettin D, Wuisman P, Winkelmann W. High complication rates with pelvic allografts. Experience of 22 sarcoma resections. Acta Orthop Scand. 1996;67(4):333–8.

    Article  CAS  PubMed  Google Scholar 

  25. Gebert C, Wessling M, Hoffmann C, Roedl R, Winkelmann W, Gosheger G, et al. Hip transposition as a limb salvage procedure following the resection of periacetabular tumors. J Surg Oncol. 2011;103(3):269–75.

    Article  PubMed  Google Scholar 

  26. Schwartz AJ, Kiatisevi P, Eilber FC, Eilber FR, Eckardt JJ. The Friedman-Eilber resection arthroplasty of the pelvis. Clin Orthop Relat Res. 2009;467(11):2825–30.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Puri A, Pruthi M, Gulia A. Outcomes after limb sparing resection in primary malignant pelvic tumors. Eur J Surg Oncol. 2014;40(1):27–33.

    Article  CAS  PubMed  Google Scholar 

  28. Puchner SE, Funovics PT, Böhler C, Kaider A, Stihsen C, Hobusch GM, et al. Oncological and surgical outcome after treatment of pelvic sarcomas. PLoS One. 2017;12(2):e0172203.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  29. Jaiswal PK, Aston WJS, Grimer RJ, Abudu A, Carter S, Blunn G, et al. Peri-acetabular resection and endoprosthetic reconstruction for tumours of the acetabulum. J Bone Joint Surg Br. 2008;90(9):1222–7.

    Article  CAS  PubMed  Google Scholar 

  30. Bus MPA, Boerhout EJ, Bramer JAM, Dijkstra PDS. Clinical outcome of pedestal cup endoprosthetic reconstruction after resection of a peri-acetabular tumour. Bone Joint J. 2014;96-B(12):1706–12.

    Article  CAS  PubMed  Google Scholar 

  31. Hipfl C, Stihsen C, Puchner SE, Kaider A, Dominkus M, Funovics PT, et al. Pelvic reconstruction following resection of malignant bone tumours using a stemmed acetabular pedestal cup. Bone Joint J. 2017;99-B(6):841–8.

    Article  CAS  PubMed  Google Scholar 

  32. Hobusch GM, Tiefenboeck TM, Patsch J, Krall C, Holzer G. Do patients after chondrosarcoma treatment have age-appropriate bone mineral density in the long term? Clin Orthop Relat Res. 2016;474(6):1508–15.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Aljassir F, Beadel GP, Turcotte RE, Griffin AM, Bell RS, Wunder JS, et al. Outcome after pelvic sarcoma resection reconstructed with saddle prosthesis. Clin Orthop Relat Res. 2005;438:36–41.

    Article  PubMed  Google Scholar 

  34. Campanacci D, Chacon S, Mondanelli N, Beltrami G, Scoccianti G, Caff G, et al. Pelvic massive allograft reconstruction after bone tumour resection. Int Orthop. 2012;36(12):2529–36.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Langlais F, Lambotte JC, Thomazeau H. Long-term results of hemipelvis reconstruction with allografts. Clin Orthop Relat Res. 2001;388:178–86.

    Article  Google Scholar 

  36. Riedel RF, Larrier N, Dodd L, Kirsch D, Martinez S, Brigman BE. The clinical management of chondrosarcoma. Curr Treat Options Oncol. 2009;10(1–2):94–106.

    Article  PubMed  Google Scholar 

  37. Bovée JVMG, Cleton-Jansen A-M, Taminiau AHM, Hogendoorn PCW. Emerging pathways in the development of chondrosarcoma of bone and implications for targeted treatment. Lancet Oncol. 2005;6(8):599–607.

    Article  PubMed  CAS  Google Scholar 

  38. van Oosterwijk JG, Herpers B, Meijer D, Briaire-de Bruijn IH, Cleton-Jansen AM, Gelderblom H, et al. Restoration of chemosensitivity for doxorubicin and cisplatin in chondrosarcoma in vitro: BCL-2 family members cause chemoresistance. Ann Oncol. 2012;23(6):1617–26.

    Article  PubMed  Google Scholar 

  39. Polychronidou G, Karavasilis V, Pollack SM, Huang PH, Lee A, Jones RL. Novel therapeutic approaches in chondrosarcoma. Future Oncol. 2017;13(7):637–48.

    Article  CAS  PubMed  Google Scholar 

  40. Donati D, El Ghoneimy A, Bertoni F, Di Bella C, Mercuri M. Surgical treatment and outcome of conventional pelvic chondrosarcoma. J Bone Joint Surg Br. 2005;87(11):1527–30.

    Article  CAS  PubMed  Google Scholar 

  41. Lex JR, Evans S, Stevenson JD, Parry M, Jeys LM, Grimer RJ. Dedifferentiated chondrosarcoma of the pelvis: clinical outcomes and current treatment. Clin Sarcoma Res. 2018;8:23.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Ozaki T, Hillmann A, Lindner N, Blasius S, Winkelmann W. Chondrosarcoma of the pelvis. Clin Orthop Relat Res. 1997;337:226–39.

    Article  Google Scholar 

  43. Sheth DS, Yasko AW, Johnson ME, Ayala AG, Murray JA, Romsdahl MM. Chondrosarcoma of the pelvis. Prognostic factors for 67 patients treated with definitive surgery. Cancer. 1996;78(4):745–50.

    Article  CAS  PubMed  Google Scholar 

  44. Chen L, Long C, Liu J, Duan X, Xiang Z. Prognostic nomograms to predict overall survival and cancer-specific survival in patients with pelvic chondrosarcoma. Cancer Med. 2019;8(12):5438–49.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Weber KL, Pring ME, Sim FH. Treatment and outcome of recurrent pelvic chondrosarcoma. Clin Orthop Relat Res. 2002;397:19–28.

    Article  Google Scholar 

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Authors and Affiliations

  1. Medical University of Vienna, Vienna, Austria

    Gerhard M. Hobusch & Reinhard Windhager

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  1. Gerhard M. Hobusch
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  2. Reinhard Windhager
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Correspondence to Reinhard Windhager .

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Editors and Affiliations

  1. Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy

    Pietro Ruggieri

  2. Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy

    Andrea Angelini

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Hobusch, G.M., Windhager, R. (2021). Chondrosarcoma of the Pelvis. In: Ruggieri, P., Angelini, A. (eds) Surgery of Pelvic Bone Tumors. Springer, Cham. https://doi.org/10.1007/978-3-030-77007-5_6

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  • DOI: https://doi.org/10.1007/978-3-030-77007-5_6

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