Chondrosarcoma of Bone: Lessons From 46 Operated Cases in a Single Institution
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Bone chondrosarcomas are rare malignant tumors that have variable biologic behavior, and their treatment is controversial. For low-grade tumors, there is no consensus on whether intralesional en bloc resections are the best treatment.
We therefore compared patients with Grade 1 and Grade 2 primary central chondrosarcomas to (1) determine difference in survival and (2) local recurrence rates; and (3) determine any association of histological grade with some clinical and demographic characteristics.
We retrospectively reviewed 46 patients with grade 1 and 2 chondrosarcomas. There were 25 men and 21 women with a mean age of 43 years (range, 17–79 years). Minimum followup was 32 months (mean, 99 months; range, 32–312 months) for the patients who remained alive in the end of the study. Twenty-three of the tumors were intracompartmental (Enneking A); of these, 19 were Grade 1 and 4 were Grade 2. Twenty-three tumors were extracompartmental (Enneking B); of these, 4 were Grade 1 and 19 were Grade 2. Twenty-five patients underwent intralesional resection, 18 had wide resection, and three had amputations.
The overall survival rate was 94% and the disease-free survival rate was 90%. Among the 23 Grade 1 tumors, we observed six local recurrences and none of these patients died; among the 23 Grade 2 tumors, 10 recurred and two patients died. Local recurrence negatively influenced survival.
For lesions with radiographic characteristics of intracompartmental Grade 1 chondrosarcoma, we believe intralesional resection followed by electrocauterization and cement is the best treatment. When the imaging suggests aggressive (Grade 2 or 3) chondrosarcoma, then wide resection is promptly indicated.
Level of Evidence
Level IV, case series. See Guidelines for Authors for a complete description of levels of evidence.
KeywordsLocal Recurrence Histological Grade Chondrosarcomas Local Recurrence Rate Soft Tissue Mass
We thank Tomaz Puga Leivas for his contribution in the statistical analysis of this study.
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