The Identification of Prognostic Factors and Survival Statistics of Conventional Central Chondrosarcoma

Nota, Sjoerd; Braun, Yvonne; Schwab, Joseph H.; Dijk, C. Niek van; Bramer, Jos A. M.

doi:10.1155/2015/623746

Cited by 88 publications

(85 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…From 0% LR and MD [18, 19], 2% LR and 0% MD [20], 3% LR and 3% MD [21], 4% LR and 0% MD [22], 5% LR and 0% MD [23], 6% LR and 0% MD [24, 25], 9% LR and 0% MD [26], 11% LR and 3% MD [27], 13% LR and 4% MD [28], 13% LR and 5% MD [29] to 18% LR and 6% MD [7] a variety of different results are reported. 5-year survival ranges from 82 to 99% and 10-year survival from 89 to 95% [8]. This reflects the problem of differentiation of benign enchondromas and atypical cartilaginous tumor and the heterogenous distribution of therapy and localization in these studies [3, 30–32].…”

Section: Discussionmentioning

confidence: 99%

“…Does localization as for example in the pelvis have a higher impact on survival than surgical margins taken for themselves? In a metaanalysis on 1114 patients published in 2015, the surgical margin were not identified as an independent predictor of overall survival [8]. In consequence, the traditional dogma of adequate margins, as stated by some authors [9, 10] had to be called into question.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Survival and prognostic factors in conventional central chondrosarcoma

Fromm¹,

Klein²,

Baur‐Melnyk

et al. 2018

BMC Cancer

View full text Add to dashboard Cite

BackgroundChondrosarcoma 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?MethodsFrom 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.ResultsIn 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.ConclusionsThe 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.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Survival and prognostic factors in conventional central chondrosarcoma

Fromm¹,

Klein²,

Baur‐Melnyk

et al. 2018

BMC Cancer

View full text Add to dashboard Cite

show abstract

“…Therefore, an inter-and intraobserver agreement study using clinicians as evaluators diagnosing these lesions is important because the orthopaedic oncologists' initial diagnosis will define the initial management implemented, and their disagreement can lead to an entirely different course of action and possibly affect the patients' outcomes. Thus, to identify how accurate the clinicians are with their diagnosis and initial treatment strategies could be an important step in determining the reasons for the mixed results that we have had with time with this type of tumor, especially when considering oncologic survival [22]. Our results showed only fair interobserver agreement for diagnosis and grading of cartilaginous neoplasms and poor agreement for proposed patient management by orthopaedic oncologists.…”

Section: Discussionmentioning

confidence: 77%

Do Orthopaedic Oncologists Agree on the Diagnosis and Treatment of Cartilage Tumors of the Appendicular Skeleton?

Zamora

Urrutia

Schweitzer

et al. 2017

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Distinguishing a benign enchondroma from a low-grade chondrosarcoma is a common diagnostic challenge for orthopaedic oncologists. Low interrater agreement has been observed for the diagnosis of cartilaginous neoplasms among radiologists and pathologists, but, to our knowledge, no study has evaluated inter-and intraobserver agreement among orthopaedic oncologists grading these lesions using initial clinical and imaging information. Determining such agreement is important since it reflects the certainty in the diagnosis by orthopaedic oncologists. Agreement also is important as it will guide future treatment and prognosis, considering that there is no gold standard for diagnosis of these lesions. Questions/Purposes (1) to determine inter-and intraobserver agreement among a multinational panel of expert orthopaedic oncologists in diagnosing cartilaginous neoplasms based on their assessment of clinical symptoms and imaging at diagnosis. (2) To describe the most important clinical and imaging features that experts use during the initial diagnostic process. (3) To determine interobserver agreement for proposed initial treatment strategies for cartilaginous neoplasms by this panel of evaluators. Methods Thirty-nine patients with intramedullary cartilaginous neoplasms of the appendicular skeleton of various histopathologic grades were selected and classified as having benign, low-grade malignant, or intermediate-or high-grade malignant neoplasms by 10 experienced orthopaedic oncologists based on clinical and imaging information. Additionally, they chose the three most important clinical or imaging features for the diagnosis of these neoplasms, and they proposed a treatment strategy for each patient. The Kappa coefficient (j) was used to determine inter-and intraobserver agreement. Results Inter-and intraobserver agreements were only fair to good, j = 0.44(95% CI, 0.41-0.48) and j = 0.62 (95% CI, 0.52-0.72), respectively. The three factors most frequently identified as helpful in making the diagnosis by our panel were cortical involvement in 65% of evaluations (253/390), neoplasm size in 51% (198/390), and pain in 50% (194/390). The interobserver agreement for the proposed initial treatment strategy after diagnosis was poor (j = 0.21; 95% CI, 0.18-0.24). Conclusions This study showed barely fair interobserver and fair to good intraobserver agreement for grading of intramedullary cartilaginous neoplasms by orthopaedic oncologists using initial clinical and imaging findings. These results reflect the insufficient guidance interpreting clinical and imaging features, and the limitations of the systems we use today when making these diagnoses. In the same way, they generate concern for the implications that this may have on different treatment strategies and the future prognosis of our patients. Future studies should build

show abstract

“…The remaining (∼10%) of conventional chondrosarcomas is of high‐grade (grade III), showing an increased cellularity, mitotic activity, cellular pleomorphism, and commonly metastasize. The 10‐year survival of grades I, II, and III conventional chondrosarcomas is 89–95, 58–86, and 0–55%, respectively, while for unresectable tumors (e.g., of the pelvis) outcome is 48% at 1 year and 2% at 5 years . Recurrence of conventional chondrosarcoma has the potential of progression towards a higher‐grade .…”

Section: Discussionmentioning

confidence: 99%

5′‐methylschweinfurthin G reduces chondrosarcoma tumor growth

Stevens

Meyerholz

Neighbors³

et al. 2017

Journal Orthopaedic Research

View full text Add to dashboard Cite

New treatment options are urgently required in the field of chondrosarcoma, particularly of chondrosarcomas with a well-differentiated hyaline cartilage-like extracellular matrix (e.g., collagen II and proteoglycan-rich) phenotype, notoriously resistant to drug penetration, and having potential of progression towards higher grade. We investigated the feasibility of using 5'-methylschweinfurthin G (MeSG) as a tumor suppressor agent in the Swarm rat chondrosarcoma, an intermediate- to high-grade chondrosarcoma model, having a hyaline cartilage-like phenotype. Tumor cell culture studies were performed to identify their proliferative and cytotoxicity sensitivity to MeSG. Tumor burden mice were treated with MeSG and analyzed for tumor growth, morphology and regression. The chondrosarcoma tumor cells had a half maximum cytotoxicity concentration (IC ) of 35 nM MeSG; approximately 300-fold less than freshly isolated rat chondrocytes (IC of 11 µM). Multiple injections of MeSG (20 mg/kg, body weight) resulted in reduced/eliminated tumor growth over a 17-day period in mice, and an 83% reduction (p = 0.023) in tumor mass. Three out of ten MeSG treated mice had complete elimination of tumor. Tumors of treated mice had a decrease in chondrosarcoma cell proliferation (p = 0.012) and an increase in cell death (p = 0.030) compared with tumors of control mice. These findings in an animal model demonstrate the effectiveness of MeSG for treatment of rat chondrosarcomas, and may have the potential use as a therapeutic option for the difficult-to-treat intermediate-to high-grade hyaline cartilage-like chondrosarcoma. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1283-1293, 2018.

show abstract

The Identification of Prognostic Factors and Survival Statistics of Conventional Central Chondrosarcoma

Cited by 88 publications

References 32 publications

Survival and prognostic factors in conventional central chondrosarcoma

Survival and prognostic factors in conventional central chondrosarcoma

Do Orthopaedic Oncologists Agree on the Diagnosis and Treatment of Cartilage Tumors of the Appendicular Skeleton?

5′‐methylschweinfurthin G reduces chondrosarcoma tumor growth

Contact Info

Product

Resources

About