The Clinical Management of Chondrosarcoma

Abstract

Chondrosarcomas (CHS) represent a heterogeneous group of disorders ranging from indolent, low-grade tumors to aggressive, high-grade forms. Surgical resection represents the primary and preferred treatment modality for individuals with localized disease. Radiation therapy is appropriate for the treatment of positive surgical margins or palliation of disease-related symptoms. The treatment of advanced, metastatic disease is particularly challenging given the recognition that conventional chemotherapy has proven to be largely ineffective. Systemic chemotherapy may be considered in variant forms such as mesenchymal or dedifferentiated chondrosarcomas but high-quality data supporting its use is limited. There is universal agreement, however, that novel treatment strategies are desperately needed. This review will highlight the need for a coordinated multidisciplinary approach to optimize the management and care of patients.

Case Report: Mesenchymal Chondrosarcoma of the Lumbar Spine in a Child

“…The prognosis of mesenchymal chondrosarcoma is usually poor (Table 1), but recent studies with modern therapy have shown improved survival [3,16]. The course of mesenchymal chondrosarcoma may be protracted, with a tendency to late local recurrence and metastasis [11].…”

Insights into Enchondroma, Enchondromatosis and the risk of secondary Chondrosarcoma. Review of the literature with an emphasis on the clinical behaviour, radiology, malignant transformation and the follow up

“…The overall survival rate at five years is approximately 90% [10,71]. However, several other studies report mortality rates of 11% to 16% with >5-year follow-up [16].…”

“…Large lesions and chondrosarcomas in anatomic locations that do not allow adequate margins or complete excision (e.g. spine, craniofacial region, ribs and pelvis) have an obvious increased risk of local recurrence and metastatic disease [70,71].…”

Local Control of Soft Tissue and Bone Sarcomas

“…Given the predominance for axial locations, negative-margin surgery is often more technically challenging. 50,51 Nonetheless, complete resection is essential because any residual tumor cells will likely lead to local recurrence. With no adjuvant support from XRT or chemotherapy, marginal margins are extremely high risk.…”