Chondrosarcoma: an analysis of clinical characteristics, treatment outcomes, and prognostic factors in a decade-long single center experience

Abstract

Aim: Management of chondrosarcoma patients is associated with histologic subtypes and clinical behaviors. This study describes our institution's management and outcome experience for 12 chondrosarcoma patients with higher grades in rarer locations. Materials and Methods: Pathologically diagnosed chondrosarcoma patients between January 2013 and January 2023 were retrospectively scanned. Patients under 18 years, duplicate records, second primary malignancy, index surgery at another hospital were excluded, and data of remaining 12 patients were statistically analyzed. Results: Twelve patients (6 female, 6 male) had median age of 62 (21-94) years. Locations of primary tumors were femur (n=4), larynx (n=1), left gluteus (n=1), lung (n=1), periscapular soft tissue (n=1), tarsal bone (n=1), distal metacarps (n=1), scapula (n=1), and sternum (n=1). There were local relapses in three cases (chest wall, ipsilateral femur, acetabulum, and ipsilateral gluteal region) and distant metastasis in three cases (contralateral lung, lung, bilateral lung, and pleura) during the follow-up. The median tumor size was 5.65cm (1.5-21.5cm). Histologic subtypes were Chondrosarcoma (Grade I) (n=4), Chondrosarcoma (Grade II) (n=1), Chondrosarcoma (Grade III) (n=2), Dedifferentiated Chondrosarcoma (Grade III) (n=2), Extraskeletal Mesenchymal Chondrosarcoma (n=3). Surgical treatment was eight wide resections, one lobectomy, one laryngectomy, one amputation, and one curettage. Five patients received chemotherapy (2 neoadjuvant chemotherapy, 3 adjuvant chemotherapy), two patients received low dose (50.4Gy) (3DCRT; IMRT), and two patients received high dose (>60Gy) (IMRT) adjuvant radiation therapy. The median follow-up was 26.5 months (2-121 months). The median survival was 26.5 months (2-121 months). Median relapse-free survival was three months (0-96 months). The overall and relapse-free survivals at two years were 81.5% and 50%; at five years, 71.3% and 25%. Conclusion: Our results demonstrate that surgery is the gold standard treatment, but well-managed adjuvant oncologic treatment provides undeniable advantage for overall survival in selected cases.