Risk factors for survival and local control in chondrosarcoma of bone

We analyze the delay in diagnosis and tumor size of malignant bone tumors of the foot in a retrospective study. We compared the oncological and surgical long-term results with identical tumor at other anatomical sites in order to analyze the biological behavior of sarcomas that are found in the foot. Thirty-two patients with a histologically proven malignant bone tumor (fifteen chondrosarcomas, nine osteosarcomas, and eight Ewing sarcomas) between the years 1969 and 2008 were included. The median follow-up was 11.9 years. The overall median time gap between the beginning of symptoms and diagnosis in the study group was 10 months. Ewing sarcoma presented with the longest delay in diagnosis (median of 18 months), followed by osteosarcoma (median of 15 months) and chondrosarcoma (median of 7.5 months). The delay in diagnosis of these tumors was significantly longer than that of equivalent tumors at other skeletal sites, but the 5- and 10-year survival rates and the occurrence of distant metastases were comparable. In contrast, the average size of foot tumors was 5- to 30-fold less than that of tumors analyzed at other skeletal sites. This study indicates that sarcomas of the foot demonstrate a distinct biological behavior compared to the same tumor types at other skeletal sites.

“…In summary, patients with a local recurrence have a worse survival rate, accompanied by a higher rate of distant metastases. This phenomenon is well known in the literature too [19, 25]. …”

Section: Discussionmentioning

confidence: 74%

Do Malignant Bone Tumors of the Foot Have a Different Biological Behavior than Sarcomas at Other Skeletal Sites?

Brotzmann

Hefti

Baumhoer

et al. 2013

“…These data strongly suggest the existence of cancer stem cells possibly with mesenchymal stem cells or fibroblast markers. Although most of the literature on chondrosarcoma has confirmed that adequate surgery is the mainstay of treatment for local tumour control, which itself constitutes a risk factor for survival, an additional feature of chondrosarcoma is also the high level of local recidive even in case of adequate surgery [38–40]. This feature is also in favour of the existence of cancer stem cells in the bone marrow which may remain dormant until some yet unknown signals promote their growth or/and metastasis formation in bone tissue.…”

Section: The Bone Niche Of Chondrosarcomamentioning

confidence: 99%

The Bone Niche of Chondrosarcoma: A Sanctuary for Drug Resistance, Tumour Growth and also a Source of New Therapeutic Targets

David

Blanchard

Heymann

et al. 2011

Chondrosarcomas are malignant cartilage-forming tumours representing around 20% of malignant primary tumours of bone and affect mainly adults in the third to sixth decade of life. Unfortunately, the molecular pathways controlling the genesis and the growth of chondrosarcoma cells are still not fully defined. It is well admitted that the invasion of bone by tumour cells affects the balance between early bone resorption and formation and induces an “inflammatory-like” environment which establishes a dialogue between tumour cells and their environment. The bone tumour microenvironment is then described as a sanctuary that contributes to the drug resistance patterns and may control at least in part the tumour growth. The concept of “niche” defined as a specialized microenvironment that can promote the emergence of tumour stem cells and provide all the required factors for their development recently emerges in the literature. The present paper aims to summarize the main evidence sustaining the existence of a specific bone niche in the pathogenesis of chondrosarcomas.

“…Chondrosarcomas can progress from low grade to high grade, which is reflected by increased cellularity, nuclear atypia, mucomyxoid matrix changes, and increased vascularization [3, 4]. Low-grade chondrosarcomas are locally aggressive but rarely metastasize [5].…”

Section: Introductionmentioning

confidence: 99%

“…Low-grade chondrosarcomas are locally aggressive but rarely metastasize [5]. By contrast, high-grade chondrosarcomas often metastasize and are lethal in most patients [3]. The molecular mechanisms involved in the progression to high-grade chondrosarcoma are beginning to be unravelled [1].…”

Section: Introductionmentioning

confidence: 99%

Involvement of the Soluble Urokinase Receptor in Chondrosarcoma Cell Mobilization

Bifulco¹,

Longanesi-Cattani²,

Masucci³

et al. 2011

High levels of urokinase receptor (uPAR) in tissue and serum of patients with chondrosarcoma correlate with poor prognosis. First, we analyzed the uPAR levels in tissues and plasma of five patients affected by chondrosarcoma. Interestingly, very high levels of uPAR and its soluble forms (SuPAR) were found on tumor cell surfaces and plasma, respectively, of two patients with lung metastases. Therefore, to investigate the role of SuPAR in chondrosaromas, we generated a primary cell culture from a chondrosarcoma tissue overexpressing uPAR on cell surfaces. We found that chondrosarcoma-like primary culture cells release a large amount of SuPAR in the medium. In vitro, SuPAR elicits chondrosarcoma cell migration likely through its uPAR88-92 sequence, since the DII88-183 or DIIDIIR88-284 uPAR domains retain motogen effect whereas DI1-87 or DIII184-284 domains, both lacking the uPAR88-92 sequence, are ineffective. Chondrosarcoma cells cross matrigel in response to SuPAR, and their invasion capability is abrogated by RERF peptide which inhibits uPAR88-92 signalling. These findings assign a role to uPAR in mobilizing chondrosarcoma cells and suggest that RERF peptide may be regarded as a prototype to generate new therapeutics for the chondrosarcoma treatment.