Skip to main content
Top
Published in: World Journal of Surgical Oncology 1/2019

Open Access 01-12-2019 | Chondrosarcoma | Research

Survival and prognostic factors in conventional G1 chondrosarcoma

Authors: Julian Fromm, Alexander Klein, Andrea Baur-Melnyk, Thomas Knösel, Lars Lindner, Christof Birkenmaier, Falk Roeder, Volkmar Jansson, Hans Roland Dürr

Published in: World Journal of Surgical Oncology | Issue 1/2019

Login to get access

Abstract

Background

Chondrosarcoma is the second most frequent malignant bone tumor. Grade I chondrosarcoma (syn.: atypical cartilaginous tumor) is classified as an intermediately and locally aggressive neoplasm and typically is treated less aggressively (i.e., by intralesional curettage). Does the data regarding local recurrence (LR) and metastatic disease justify this?

Methods

From 1982 to 2014, 37 consecutive patients with G1 chondrosarcoma had been resected or curetted. The margin was defined as R0 (wide resection) or R1 (marginal resection). All patients were followed for evidence of local recurrence or metastatic disease. Overall and recurrence-free survival were calculated, and various potentially prognostic factors were evaluated.

Results

In 23 patients (62%), the tumor was widely (R0) resected, whereas in 14 patients, (38%) the resection was marginal (R1). Overall survival was 97% after 5 years, 92% after 10 years, and 67% after 20 years. Five-year local recurrence-free survival was 96%. Ten-year local recurrence-free survival was 83%. Local recurrence-free survival showed a significant correlation to margin status but no correlation to location or age. None of the patients with local recurrence died during the follow-up. One patient had metastatic disease at initial presentation, and a further five patients developed metastatic disease during follow-up. Metastatic disease proofed to be a highly significant factor for survival but was not correlated to local recurrence.

Conclusions

There was no significant correlation between the outcome and the primary tumor location. Marginal resection was a risk factor for LR, but there was no significant difference in the overall survival in patients with or without LR. Metastatic disease (16%) was more common than expected from the literature and a significant predictor for poor overall survival.
Literature
1.
go back to reference Doyle LA. Sarcoma classification: an update based on the 2013 World Health Organization classification of tumors of soft tissue and bone. Cancer. 2014;120:1763–74.CrossRef Doyle LA. Sarcoma classification: an update based on the 2013 World Health Organization classification of tumors of soft tissue and bone. Cancer. 2014;120:1763–74.CrossRef
2.
go back to reference Bindiganavile S, Han I, Yun JY, Kim HS. Long-term outcome of chondrosarcoma: a single institutional experience. Cancer Res Treat. 2015;47:897–903.CrossRef Bindiganavile S, Han I, Yun JY, Kim HS. Long-term outcome of chondrosarcoma: a single institutional experience. Cancer Res Treat. 2015;47:897–903.CrossRef
3.
go back to reference Di Giorgio L, Touloupakis G, Vitullo F, Sodano L, Mastantuono M, Villani C. Intralesional curettage, with phenol and cement as adjuvants, for low-grade intramedullary chondrosarcoma of the long bones. Acta Orthop Belg. 2011;77:666–9.PubMed Di Giorgio L, Touloupakis G, Vitullo F, Sodano L, Mastantuono M, Villani C. Intralesional curettage, with phenol and cement as adjuvants, for low-grade intramedullary chondrosarcoma of the long bones. Acta Orthop Belg. 2011;77:666–9.PubMed
4.
go back to reference Puri A, Shah M, Agarwal MG, Jambhekar NA, Basappa P. Chondrosarcoma of bone: does the size of the tumor, the presence of a pathologic fracture, or prior intervention have an impact on local control and survival? J Cancer Res Ther. 2009;5:14–9.CrossRef Puri A, Shah M, Agarwal MG, Jambhekar NA, Basappa P. Chondrosarcoma of bone: does the size of the tumor, the presence of a pathologic fracture, or prior intervention have an impact on local control and survival? J Cancer Res Ther. 2009;5:14–9.CrossRef
5.
go back to reference Outani H, Hamada K, Imura Y, Oshima K, Sotobori T, Demizu Y, Kakunaga S, Joyama S, Imai R, Okimoto T, et al. Comparison of clinical and functional outcome between surgical treatment and carbon ion radiotherapy for pelvic chondrosarcoma. Int J Clin Oncol. 2016;21:186–93.CrossRef Outani H, Hamada K, Imura Y, Oshima K, Sotobori T, Demizu Y, Kakunaga S, Joyama S, Imai R, Okimoto T, et al. Comparison of clinical and functional outcome between surgical treatment and carbon ion radiotherapy for pelvic chondrosarcoma. Int J Clin Oncol. 2016;21:186–93.CrossRef
6.
go back to reference van Maldegem AM, Gelderblom H, Palmerini E, Dijkstra SD, Gambarotti M, Ruggieri P, Nout RA, van de Sande MA, Ferrari C, Ferrari S, et al. Outcome of advanced, unresectable conventional central chondrosarcoma. Cancer. 2014;120:3159–64.CrossRef van Maldegem AM, Gelderblom H, Palmerini E, Dijkstra SD, Gambarotti M, Ruggieri P, Nout RA, van de Sande MA, Ferrari C, Ferrari S, et al. Outcome of advanced, unresectable conventional central chondrosarcoma. Cancer. 2014;120:3159–64.CrossRef
7.
go back to reference Gelderblom H, Hogendoorn PC, Dijkstra SD, van Rijswijk CS, Krol AD, Taminiau AH, Bovee JV. The clinical approach towards chondrosarcoma. Oncologist. 2008;13:320–9.CrossRef Gelderblom H, Hogendoorn PC, Dijkstra SD, van Rijswijk CS, Krol AD, Taminiau AH, Bovee JV. The clinical approach towards chondrosarcoma. Oncologist. 2008;13:320–9.CrossRef
8.
go back to reference Donati D, Colangeli S, Colangeli M, Di Bella C, Bertoni F. Surgical treatment of grade I central chondrosarcoma. Clin Orthop Relat Res. 2010;468:581–9.CrossRef Donati D, Colangeli S, Colangeli M, Di Bella C, Bertoni F. Surgical treatment of grade I central chondrosarcoma. Clin Orthop Relat Res. 2010;468:581–9.CrossRef
9.
go back to reference Chen YC, Wu PK, Chen CF, Chen WM. Intralesional curettage of central low-grade chondrosarcoma: a midterm follow-up study. J Chin Med Assoc. 2017;80:178–82.CrossRef Chen YC, Wu PK, Chen CF, Chen WM. Intralesional curettage of central low-grade chondrosarcoma: a midterm follow-up study. J Chin Med Assoc. 2017;80:178–82.CrossRef
10.
go back to reference Fiorenza F, Abudu A, Grimer RJ, Carter SR, Tillman RM, Ayoub K, Mangham DC, Davies AM. Risk factors for survival and local control in chondrosarcoma of bone. J Bone Joint Surg Br. 2002;84:93–9.CrossRef Fiorenza F, Abudu A, Grimer RJ, Carter SR, Tillman RM, Ayoub K, Mangham DC, Davies AM. Risk factors for survival and local control in chondrosarcoma of bone. J Bone Joint Surg Br. 2002;84:93–9.CrossRef
11.
go back to reference Chen X, Yu LJ, Peng HM, Jiang C, Ye CH, Zhu SB, Qian WW. Is intralesional resection suitable for central grade 1 chondrosarcoma: a systematic review and updated meta-analysis. Eur J Surg Oncol. 2017;43:1718–26.CrossRef Chen X, Yu LJ, Peng HM, Jiang C, Ye CH, Zhu SB, Qian WW. Is intralesional resection suitable for central grade 1 chondrosarcoma: a systematic review and updated meta-analysis. Eur J Surg Oncol. 2017;43:1718–26.CrossRef
12.
go back to reference Andreou D, Gilg MM, Gosheger G, Werner M, Hardes J, Pink D, Leithner A, Tunn PU, Streitburger A. Metastatic potential of grade I chondrosarcoma of bone: results of a multi-institutional study. Ann Surg Oncol. 2016;23:120–5.CrossRef Andreou D, Gilg MM, Gosheger G, Werner M, Hardes J, Pink D, Leithner A, Tunn PU, Streitburger A. Metastatic potential of grade I chondrosarcoma of bone: results of a multi-institutional study. Ann Surg Oncol. 2016;23:120–5.CrossRef
13.
go back to reference Bergh P, Gunterberg B, Meis-Kindblom JM, Kindblom LG. Prognostic factors and outcome of pelvic, sacral, and spinal chondrosarcomas: a center-based study of 69 cases. Cancer. 2001;91:1201–12.CrossRef Bergh P, Gunterberg B, Meis-Kindblom JM, Kindblom LG. Prognostic factors and outcome of pelvic, sacral, and spinal chondrosarcomas: a center-based study of 69 cases. Cancer. 2001;91:1201–12.CrossRef
14.
go back to reference Jodi M, Carter CYI. Conventional chondrosarcoma: old controversies and new insights. Diagn Histopathol. 2014;20:181–90.CrossRef Jodi M, Carter CYI. Conventional chondrosarcoma: old controversies and new insights. Diagn Histopathol. 2014;20:181–90.CrossRef
15.
go back to reference Funovics PT, Panotopoulos J, Sabeti-Aschraf M, Abdolvahab F, Funovics JM, Lang S, Kotz RI, Dominkus M. Low-grade chondrosarcoma of bone: experiences from the Vienna Bone and Soft Tissue Tumour Registry. Int Orthop. 2011;35:1049–56.CrossRef Funovics PT, Panotopoulos J, Sabeti-Aschraf M, Abdolvahab F, Funovics JM, Lang S, Kotz RI, Dominkus M. Low-grade chondrosarcoma of bone: experiences from the Vienna Bone and Soft Tissue Tumour Registry. Int Orthop. 2011;35:1049–56.CrossRef
16.
go back to reference Bjornsson J, McLeod RA, Unni KK, Ilstrup DM, Pritchard DJ. Primary chondrosarcoma of long bones and limb girdles. Cancer. 1998;83:2105–19.CrossRef Bjornsson J, McLeod RA, Unni KK, Ilstrup DM, Pritchard DJ. Primary chondrosarcoma of long bones and limb girdles. Cancer. 1998;83:2105–19.CrossRef
17.
go back to reference 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;91:1063–72.CrossRef 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;91:1063–72.CrossRef
18.
go back to reference de Camargo OP, Baptista AM, Atanasio MJ, Waisberg DR. Chondrosarcoma of bone: lessons from 46 operated cases in a single institution. Clin Orthop Relat Res. 2010;468:2969–75.CrossRef de Camargo OP, Baptista AM, Atanasio MJ, Waisberg DR. Chondrosarcoma of bone: lessons from 46 operated cases in a single institution. Clin Orthop Relat Res. 2010;468:2969–75.CrossRef
19.
go back to reference Hanna SA, Whittingham-Jones P, Sewell MD, Pollock RC, Skinner JA, Saifuddin A, Flanagan A, Cannon SR, Briggs TW. Outcome of intralesional curettage for low-grade chondrosarcoma of long bones. Eur J Surg Oncol. 2009;35:1343–7.CrossRef Hanna SA, Whittingham-Jones P, Sewell MD, Pollock RC, Skinner JA, Saifuddin A, Flanagan A, Cannon SR, Briggs TW. Outcome of intralesional curettage for low-grade chondrosarcoma of long bones. Eur J Surg Oncol. 2009;35:1343–7.CrossRef
20.
go back to reference Meftah M, Schult P, Henshaw RM. Long-term results of intralesional curettage and cryosurgery for treatment of low-grade chondrosarcoma. J Bone Joint Surg Am. 2013;95:1358–64.CrossRef Meftah M, Schult P, Henshaw RM. Long-term results of intralesional curettage and cryosurgery for treatment of low-grade chondrosarcoma. J Bone Joint Surg Am. 2013;95:1358–64.CrossRef
21.
go back to reference Kim W, Han I, Kim EJ, Kang S, Kim HS. Outcomes of curettage and anhydrous alcohol adjuvant for low-grade chondrosarcoma of long bone. Surg Oncol. 2015;24:89–94.CrossRef Kim W, Han I, Kim EJ, Kang S, Kim HS. Outcomes of curettage and anhydrous alcohol adjuvant for low-grade chondrosarcoma of long bone. Surg Oncol. 2015;24:89–94.CrossRef
22.
go back to reference Schwab JH, Wenger D, Unni K, Sim FH. Does local recurrence impact survival in low-grade chondrosarcoma of the long bones? Clin Orthop Relat Res. 2007;462:175–80.CrossRef Schwab JH, Wenger D, Unni K, Sim FH. Does local recurrence impact survival in low-grade chondrosarcoma of the long bones? Clin Orthop Relat Res. 2007;462:175–80.CrossRef
23.
go back to reference Lee FY, Mankin HJ, Fondren G, Gebhardt MC, Springfield DS, Rosenberg AE, Jennings LC. Chondrosarcoma of bone: an assessment of outcome. J Bone Joint Surg Am. 1999;81:326–38.CrossRef Lee FY, Mankin HJ, Fondren G, Gebhardt MC, Springfield DS, Rosenberg AE, Jennings LC. Chondrosarcoma of bone: an assessment of outcome. J Bone Joint Surg Am. 1999;81:326–38.CrossRef
24.
go back to reference 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;87:1527–30.CrossRef 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;87:1527–30.CrossRef
25.
go back to reference 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;78:745–50.CrossRef 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;78:745–50.CrossRef
26.
go back to reference Pant R, Yasko AW, Lewis VO, Raymond K, Lin PP. Chondrosarcoma of the scapula: long-term oncologic outcome. Cancer. 2005;104:149–58.CrossRef Pant R, Yasko AW, Lewis VO, Raymond K, Lin PP. Chondrosarcoma of the scapula: long-term oncologic outcome. Cancer. 2005;104:149–58.CrossRef
27.
go back to reference Weber KL, Pring ME, Sim FH. Treatment and outcome of recurrent pelvic chondrosarcoma. Clin Orthop Relat Res. 2002;397:19-28.CrossRef Weber KL, Pring ME, Sim FH. Treatment and outcome of recurrent pelvic chondrosarcoma. Clin Orthop Relat Res. 2002;397:19-28.CrossRef
28.
go back to reference Streitburger A, Ahrens H, Balke M, Buerger H, Winkelmann W, Gosheger G, Hardes J. Grade I chondrosarcoma of bone: the Munster experience. J Cancer Res Clin Oncol. 2009;135:543–50.CrossRef Streitburger A, Ahrens H, Balke M, Buerger H, Winkelmann W, Gosheger G, Hardes J. Grade I chondrosarcoma of bone: the Munster experience. J Cancer Res Clin Oncol. 2009;135:543–50.CrossRef
29.
go back to reference Ahlmann ER, Menendez LR, Fedenko AN, Learch T. Influence of cryosurgery on treatment outcome of low-grade chondrosarcoma. Clin Orthop Relat Res. 2006;451:201–7.CrossRef Ahlmann ER, Menendez LR, Fedenko AN, Learch T. Influence of cryosurgery on treatment outcome of low-grade chondrosarcoma. Clin Orthop Relat Res. 2006;451:201–7.CrossRef
30.
go back to reference Andreou D, Ruppin S, Fehlberg S, Pink D, Werner M, Tunn PU. Survival and prognostic factors in chondrosarcoma: results in 115 patients with long-term follow-up. Acta Orthop. 2011;82:749–55.CrossRef Andreou D, Ruppin S, Fehlberg S, Pink D, Werner M, Tunn PU. Survival and prognostic factors in chondrosarcoma: results in 115 patients with long-term follow-up. Acta Orthop. 2011;82:749–55.CrossRef
31.
go back to reference Mermerkaya MU, Bekmez S, Karaaslan F, Danisman M, Kosemehmetoglu K, Gedikoglu G, Ayvaz M, Tokgozoglu AM. Intralesional curettage and cementation for low-grade chondrosarcoma of long bones: retrospective study and literature review. World J Surg Oncol. 2014;12:336.CrossRef Mermerkaya MU, Bekmez S, Karaaslan F, Danisman M, Kosemehmetoglu K, Gedikoglu G, Ayvaz M, Tokgozoglu AM. Intralesional curettage and cementation for low-grade chondrosarcoma of long bones: retrospective study and literature review. World J Surg Oncol. 2014;12:336.CrossRef
32.
go back to reference Campanacci DA, Scoccianti G, Franchi A, Roselli G, Beltrami G, Ippolito M, Caff G, Frenos F, Capanna R. Surgical treatment of central grade 1 chondrosarcoma of the appendicular skeleton. J Orthop Traumatol. 2013;14:101–7.CrossRef Campanacci DA, Scoccianti G, Franchi A, Roselli G, Beltrami G, Ippolito M, Caff G, Frenos F, Capanna R. Surgical treatment of central grade 1 chondrosarcoma of the appendicular skeleton. J Orthop Traumatol. 2013;14:101–7.CrossRef
Metadata
Title
Survival and prognostic factors in conventional G1 chondrosarcoma
Authors
Julian Fromm
Alexander Klein
Andrea Baur-Melnyk
Thomas Knösel
Lars Lindner
Christof Birkenmaier
Falk Roeder
Volkmar Jansson
Hans Roland Dürr
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Chondrosarcoma
Published in
World Journal of Surgical Oncology / Issue 1/2019
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-019-1695-4

Other articles of this Issue 1/2019

World Journal of Surgical Oncology 1/2019 Go to the issue