Prognosis of Primary and Recurrent Chondrosarcoma of the Rib.
BACKGROUND
Chondrosarcoma of the rib is a rare disease. Although surgery is the only curative treatment option, rib resection with an adequate margin can be challenging and local recurrence is a frequent problem. In this study, the prognosis of primary and recurrent chondrosarcoma of the rib is reported.


METHODS
Retrospective analysis was performed of patients treated for chondrosarcoma of the rib between 1984 and 2014 in three major tertiary referral centers in The Netherlands. Clinical and histopathological features were analyzed for their prognostic value using Kaplan-Meier and Cox proportional hazard analysis. Endpoints were set at local recurrent disease, metastasis rate, or death.


RESULTS
Overall, 76 patients underwent a resection for a primary chondrosarcoma, and 26 patients underwent a resection for a recurrent chondrosarcoma. Five-year overall survival in the primary group was 90%, local recurrence rate was 17%, and metastasis rate was 12%. The 5-year outcome after recurrent chondrosarcoma was lower, with an overall survival of 65%, local recurrence rate of 27%, and metastasis rate of 27%. For primary chondrosarcoma, tumor size >5 cm and a positive resection margin were correlated with worse overall survival [hazard ratio (HR) 3.28, 95% confidence interval (CI) 1.03-10.44; HR 2.92, 95% CI 1.03-8.25). A higher histological grade was correlated with a higher local recurrence and metastasis rate (HR 5.92, 95% CI 1.11-31.65; HR 6.96, 95% CI 1.15-42.60).


CONCLUSIONS
Surgical resection of both primary and recurrent chondrosarcoma of the rib is an effective treatment strategy. The oncological outcome after surgery is worse in tumors >5 cm, in tumors with positive resection margins and grade 3 chondrosarcoma.
Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Eva
E
Roos
Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Frits
F
van Coevorden
Department of Surgical Oncology, Erasmus Medical Centre-Daniel den Hoed, Rotterdam, The Netherlands.
Cornelis
C
Verhoef
Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Michel W
MW
Wouters
Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
Herman M
HM
Kroon
Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands.
Pancras C W
PC
Hogendoorn
Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. w.v.houdt@nki.nl.
Winan J
WJ
van Houdt
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000473:pathology* / Q000601:surgery; D002813:Chondrosarcoma / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012272:Ribs / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D055815:Young Adult