The value of chest and skeletal staging studies in conventional chondrosarcoma.

Abstract

To determine the value of chest and skeletal staging in patients presenting with conventional chondrosarcoma (CS). Retrospective review of patients with CS diagnosed between January 2007 and December 2019. Data collected included age, sex, skeletal location and results of chest CT and whole-body bone scintigraphy (WB-BSc) obtained at initial diagnosis. The histological tumour grade based on surgical resection or needle biopsy was classified as low-grade (LGCT), high-grade (HGCT) and dedifferentiated (DD-CS). Findings of chest CT and WB-BSc were correlated with tumour grade. Four hundred twenty patients were included (234 males and 186 females with mean age 54.5years, range 9-91years). The major long bones were involved in 205 cases, the flat bones in 166 cases, the mobile spine in 14 cases and the small bones of the hands and feet in 35 cases. Three hundred fifty tumours were central in location, 39 peripheral and 31 on the surface of the bone. There were 151 LGCTs, 196 HGCTs and 73 DD-CSs. Of patients with LGCT, 41.7% underwent chest CT and 25.2% WB-BSc. Of patients with HGCT, 95.4% underwent chest CT and 76.5% WB-BSc. Of patients with DD-CS, 98.6% underwent chest CT and 86.3% WB-BSc. Metastases were diagnosed in 2 (3.3%) chest CT studies and 0 WB-BSc in LGCT, in 8 (4.3%) chest CT studies and 0 WB-BSc in HGCT and in 21 (30%) chest CT studies and 6 (21%) WB-BSc in DD-CS. Staging chest CT and WB-BSc is of little or no value except in DD-CS.