Chondrosarcoma of bone: lessons from 46 operated cases in a single institution.
BACKGROUND
Bone chondrosarcomas are rare malignant tumors that have variable biologic behavior, and their treatment is controversial. For low-grade tumors, there is no consensus on whether intralesional en bloc resections are the best treatment.


OBJECTIVE
We therefore compared patients with Grade 1 and Grade 2 primary central chondrosarcomas to (1) determine difference in survival and (2) local recurrence rates; and (3) determine any association of histological grade with some clinical and demographic characteristics.


METHODS
We retrospectively reviewed 46 patients with grade 1 and 2 chondrosarcomas. There were 25 men and 21 women with a mean age of 43 years (range, 17-79 years). Minimum followup was 32 months (mean, 99 months; range, 32-312 months) for the patients who remained alive in the end of the study. Twenty-three of the tumors were intracompartmental (Enneking A); of these, 19 were Grade 1 and 4 were Grade 2. Twenty-three tumors were extracompartmental (Enneking B); of these, 4 were Grade 1 and 19 were Grade 2. Twenty-five patients underwent intralesional resection, 18 had wide resection, and three had amputations.


RESULTS
The overall survival rate was 94% and the disease-free survival rate was 90%. Among the 23 Grade 1 tumors, we observed six local recurrences and none of these patients died; among the 23 Grade 2 tumors, 10 recurred and two patients died. Local recurrence negatively influenced survival.


CONCLUSIONS
For lesions with radiographic characteristics of intracompartmental Grade 1 chondrosarcoma, we believe intralesional resection followed by electrocauterization and cement is the best treatment. When the imaging suggests aggressive (Grade 2 or 3) chondrosarcoma, then wide resection is promptly indicated.
de Camargo
Olavo Pires
OP
Department of Orthopaedics, University of São Paulo, Rua Ovídio Pires de Campos, 333 - Cerqueira César, São Paulo, CEP 05403-010, Brazil. olapcama@uol.com.br
Baptista
André Mathias
AM
Atanásio
Marcelo Junqueira
MJ
Waisberg
Daniel Reis
DR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D001843:Bone Cements / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001938:Brazil; D002813:Chondrosarcoma / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D004564:Electrocoagulation; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D009367:Neoplasm Staging; D019637:Orthopedic Procedures / Q000401:mortality; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D001843:Bone Cements
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