Vol 71, No 6 (2021)
Research paper (original)
Published online: 2021-12-06

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The outcomes of limb-sparing surgery of patients with chondrosarcoma of the pelvis

Andrzej Pieńkowski1, Andrzej Komor23, Tomasz Goryń1, Bartłomiej Szostakowski1, Michał Wągrodzki4, Donata Makuła5, Patrycja Castaneda-Wysocka5, Wojciech Michalski6, Aneta Borkowska1, Piotr Rutkowski1
Nowotwory. Journal of Oncology 2021;71(6):336-342.

Abstract

Introduction.  Chondrosarcoma (ChSa) is the second most common primary malignant bone tumour, after osteosarco­ma. The aim of this study is to analyse the prognostic factors in patients operated on ChSa of the pelvic bone with limb sparing on the basis of a large retrospective group of patients. Aspects of the surgical technique are also presented, taking into account the location of the tumour within the pelvis. An attempt was also made to define the criteria for selecting patients for whom radical and limb-sparing surgery is possible.

Material and methods.  We analysed 53 consecutive patients with chondrosarcoma of the pelvic and sacral bones after surgery performed at the Department of Soft Tissue/Bone Sarcoma and Melanoma in Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw, Poland, between 1998 and 2020. Patients had surgery with sparing of the lower limb with the intention of cure.

Results.  There were 34 patients with G1 grade, G2 – 16, and G3 – 3. The R0 resection margin was achieved in 36 cases, the R1 margin in 11, and the R2 margin in 5 cases. The 5- and 10-year overall survival rates for the entire group were 84% and 65%, respectively. The 5-year and 10-year disease-free survival (DFS) probabilities were 65% and 43%, respectively.

Conclusions.  Multivariate analysis of the studied group of patients showed that the resection margin was a statistically significant factor determining prognosis (patients after R0 surgery margin have about 5 times lower death risk compared to patients after non-radical surgery with R1 or R2 margin).

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References

  1. Bovee JV, Flanagan AM, Lazar AJ. Bone tumors. In: Lokuhetty D, White V, Cree I. ed. WHO Classififcation of Tumours Editorial Board. Soft tissue and bone tumours. Intenrational Agency for Research on Cancer, Lyon 2020: 373–391.
  2. Limaiem F, Davis D, Sticco K. Chondrosarcoma. In: StatPearls. StatPearls Publishing, Treasure Island 2020.
  3. Ene R, Panti ZA, Nica M, et al. Chondrosarcoma of the pelvis - case report. Rom J Morphol Embryol. 2018; 59(3): 927–931.
  4. Anderson ME, Wu JS, Vargas SO. CORR® Tumor Board: Is the Width of a Surgical Margin Associated with the Outcome of Disease in Patients with Peripheral Chondrosarcoma of the Pelvis? A Multicenter Study. Clin Orthop Relat Res. 2019; 477(11): 2429–2431.
  5. Zoccali C, Baldi J, Attala D, et al. Intralesional vs. extralesional procedures for low-grade central chondrosarcoma: a systematic review of the literature. Arch Orthop Trauma Surg. 2018; 138(7): 929–937.
  6. Limaiem F, Davis D, Sticco K. Chondrosarcoma. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. 2021.
  7. Zając A, Król SK, Rutkowski P, et al. Biological Heterogeneity of Chondrosarcoma: From (Epi) Genetics through Stemness and Deregulated Signaling to Immunophenotype. Cancers (Basel). 2021; 13(6).
  8. Pring ME, Weber KL, Unni KK, et al. Chondrosarcoma of the pelvis. A review of sixty-four cases. J Bone Joint Surg Am. 2001; 83(11): 1630–1642.
  9. Sheth D, Yasko A, Johnson M, et al. Chondrosarcoma of the pelvis: Prognostic factors for 67 patients treated with definitive surgery. Cancer. 1996; 78(4): 745–750, doi: 10.1002/(sici)1097-0142(19960815)78:4<745::aid-cncr9>3.0.co;2-d.
  10. Rutkowski P, Mazurkiewicz T, Krzakowski M, et al. Zalecenia postepowania diagnostyczno-terapeutycznego u chorych na pierwotne nowotwory złośliwe kości u dorosłych. Nowotwory J Oncolology. 2011; 61(2): 159.
  11. Greenspan A, Jundt G, Remagen W. Diagnostyka różnicowa w onkologii ortopedycznej; wyd. Medipage 2008: 231–238.
  12. Kaplan EL, Meier P. Nonparametric Estimation from Incomplete Observations. J Am Stat Assoc. 1958; 53(282): 457–481.
  13. Cox DR. Regression models and life tables. J R Stat Soc B. 1972; 34: 187–220.
  14. Fromm J, Klein A, Baur-Melnyk A, et al. Survival and prognostic factors in conventional central chondrosarcoma. BMC Cancer. 2018; 18(1): 849.
  15. Chen X, Yu LJ, Peng HM, et al. Is intralesional resection suitable for central grade 1 chondrosarcoma: A systematic review and updated meta-analysis. Eur J Surg Oncol. 2017; 43(9): 1718–1726.
  16. Tsuda Y, Evans S, Stevenson JD, et al. Is the Width of a Surgical Margin Associated with the Outcome of Disease in Patients with Peripheral Chondrosarcoma of the Pelvis? A Multicenter Study. Clin Orthop Relat Res. 2019; 477(11): 2432–2440.