The effect of primary tumor resection or amputation on overall survival in patients with metastatic extremity chondrosarcoma

Abstract

Objective To compare overall survival of metastatic extremity patients treated with limb salvage and amputation. Methods Fifty-eight patients of extremity chondrosarcoma with distant metastasis were collected between 1994 and 2013 from Surveillance, Epidemiology, and End Results (SEER) database for retrospective analyses. All the patients were classified as limb salvage group (n=43) or amputation group (n=15) according to surgery type. Univariate Log-rank analysis and multivariate Cox proportional hazard regression analysis were applied to compare overall survival in these two groups. Results Among 58 extremity chondrosarcoma patients, 33 patients were males, 25 patients were females, and the median age was 61(14-88 years old). Of the patients in the cohort, 16 patients had a tumor located in upper extremity, while 42 patients had a tumor located in lower extremity. There was no significant difference in overall survival between patients treated with limb salvage and amputation (P=0.409) by univariate log-rank analysis demonstrated. In addition, multivariate Cox regression analysis including surgery type, histologic subtype and tumor grade was performed to control confounding variables. The results of multivariate analysis still suggested that there was no difference in overall survival between patients treated with limb salvage and amputation (amputation: hazard ration=1.646, 95% confidence interval=0.856-3.166, P>0.05). Conclusions There is no significant difference in overall survival between patients treated with limb salvage and amputation. Key words: Chondrosarcoma; Neoplasm metastasis; Metastasis; Amputation; Limb salvage; Overall survival