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Survival and prognostic factors in conventional central chondrosarcoma

BACKGROUND: Chondrosarcoma is the second most frequent primary malignant bone tumor. Treatment is mainly based on surgery. In general, wide resection is advocated at least in G2 and G3 tumors. But which margins should be achieved? Does localization as for example in the pelvis have a higher impact o...

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Autores principales: Fromm, Julian, Klein, Alexander, Baur-Melnyk, Andrea, Knösel, Thomas, Lindner, Lars, Birkenmaier, Christof, Roeder, Falk, Jansson, Volkmar, Dürr, Hans Roland
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6109289/
https://www.ncbi.nlm.nih.gov/pubmed/30143018
http://dx.doi.org/10.1186/s12885-018-4741-7
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author Fromm, Julian
Klein, Alexander
Baur-Melnyk, Andrea
Knösel, Thomas
Lindner, Lars
Birkenmaier, Christof
Roeder, Falk
Jansson, Volkmar
Dürr, Hans Roland
author_facet Fromm, Julian
Klein, Alexander
Baur-Melnyk, Andrea
Knösel, Thomas
Lindner, Lars
Birkenmaier, Christof
Roeder, Falk
Jansson, Volkmar
Dürr, Hans Roland
author_sort Fromm, Julian
collection PubMed
description BACKGROUND: Chondrosarcoma is the second most frequent primary malignant bone tumor. Treatment is mainly based on surgery. In general, wide resection is advocated at least in G2 and G3 tumors. But which margins should be achieved? Does localization as for example in the pelvis have a higher impact on survival than surgical margins themselves? METHODS: From 1982 to 2014, 87 consecutive patients were treated by resection. The margin was defined as R0 (wide resection), R1 (marginal resection) or, R2 if the tumor was left intentionally. All patients were followed for evidence of local recurrence or distant metastasis. Overall and recurrence-free survival were calculated, significance analysis was performed. RESULTS: In 54 (62%) cases a R0 resection, in 31 (36%) a R1 and in 2 (2%) patients a R2-resection was achieved. Histology proved to be G1 in 37 patients (43%), G2 in 41 (47%) and G3 in 9 cases (10%). 5-year local recurrence-free survival (LRFS) was 75%. Local recurrence-free survival showed a significant association with the margin status and the localization of the tumor with pelvic lesions doing worst. Metastatic disease was initially seen in 4 patients (4.6%), 19 others developed metastatic disease during follow-up. Overall survival of the entire group at 5 and 10 years were 79 and 75%, respectively. The quality of surgical margins and the presence of local recurrence did not influence overall survival in a multivariate analysis. Pelvic lesions had a worse prognosis as did higher grades of the tumor, metastatic disease and age. CONCLUSIONS: The mainstay of therapy in Chondrosarcoma remains surgery. Risk factors as grading, metastatic disease, age and location significantly influence overall survival. Margin status (R0 vs. R1) did influence local recurrence-free survival but not overall survival. Chondrosarcomas of the pelvis have a higher risk of local recurrence and should be treated more aggressively.
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spelling pubmed-61092892018-08-29 Survival and prognostic factors in conventional central chondrosarcoma Fromm, Julian Klein, Alexander Baur-Melnyk, Andrea Knösel, Thomas Lindner, Lars Birkenmaier, Christof Roeder, Falk Jansson, Volkmar Dürr, Hans Roland BMC Cancer Research Article BACKGROUND: Chondrosarcoma is the second most frequent primary malignant bone tumor. Treatment is mainly based on surgery. In general, wide resection is advocated at least in G2 and G3 tumors. But which margins should be achieved? Does localization as for example in the pelvis have a higher impact on survival than surgical margins themselves? METHODS: From 1982 to 2014, 87 consecutive patients were treated by resection. The margin was defined as R0 (wide resection), R1 (marginal resection) or, R2 if the tumor was left intentionally. All patients were followed for evidence of local recurrence or distant metastasis. Overall and recurrence-free survival were calculated, significance analysis was performed. RESULTS: In 54 (62%) cases a R0 resection, in 31 (36%) a R1 and in 2 (2%) patients a R2-resection was achieved. Histology proved to be G1 in 37 patients (43%), G2 in 41 (47%) and G3 in 9 cases (10%). 5-year local recurrence-free survival (LRFS) was 75%. Local recurrence-free survival showed a significant association with the margin status and the localization of the tumor with pelvic lesions doing worst. Metastatic disease was initially seen in 4 patients (4.6%), 19 others developed metastatic disease during follow-up. Overall survival of the entire group at 5 and 10 years were 79 and 75%, respectively. The quality of surgical margins and the presence of local recurrence did not influence overall survival in a multivariate analysis. Pelvic lesions had a worse prognosis as did higher grades of the tumor, metastatic disease and age. CONCLUSIONS: The mainstay of therapy in Chondrosarcoma remains surgery. Risk factors as grading, metastatic disease, age and location significantly influence overall survival. Margin status (R0 vs. R1) did influence local recurrence-free survival but not overall survival. Chondrosarcomas of the pelvis have a higher risk of local recurrence and should be treated more aggressively. BioMed Central 2018-08-24 /pmc/articles/PMC6109289/ /pubmed/30143018 http://dx.doi.org/10.1186/s12885-018-4741-7 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Fromm, Julian
Klein, Alexander
Baur-Melnyk, Andrea
Knösel, Thomas
Lindner, Lars
Birkenmaier, Christof
Roeder, Falk
Jansson, Volkmar
Dürr, Hans Roland
Survival and prognostic factors in conventional central chondrosarcoma
title Survival and prognostic factors in conventional central chondrosarcoma
title_full Survival and prognostic factors in conventional central chondrosarcoma
title_fullStr Survival and prognostic factors in conventional central chondrosarcoma
title_full_unstemmed Survival and prognostic factors in conventional central chondrosarcoma
title_short Survival and prognostic factors in conventional central chondrosarcoma
title_sort survival and prognostic factors in conventional central chondrosarcoma
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6109289/
https://www.ncbi.nlm.nih.gov/pubmed/30143018
http://dx.doi.org/10.1186/s12885-018-4741-7
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