High-risk extracranial chondrosarcoma: long-term results of surgery and radiation therapy.

Abstract

BACKGROUND:

A study was undertaken to evaluate results of surgery and radiotherapy (RT) for high-risk extracranial chondrosarcomas.

METHODS:

Between 1986 and 2006, 60 patients underwent surgery and RT for extracranial high-risk chondrosarcoma. Preoperative RT (median, 50 gray [Gy]) and postoperative RT (median, 60 Gy) were used in 40% and 60% patients, respectively. Sites included pelvis/lower extremity (48%), chest wall (22%), spine/paraspinal (17%), and head and neck (13%). Overall, median tumor size was 7 cm (range, 1-22 cm), and tumor grade was I, II, and III in 22%, 64%, and 14% of cases, respectively.

RESULTS:

Pathologically clear surgical margins (R0) were present in 50%, microscopic positive margins (R1) in 28%, and gross positive margins (R2) in 13%, half of whom had clinically detectable residual disease; surgical margin was unknown in 8%. Median follow-up was 75 months (range, 5-230 months). The crude local control rate was 90%. Patients with R0, R1, and R2 resections had local control of 100%, 94%, and 42%, respectively. Of the 8 cases that had R2 resection, 3 experienced uncontrolled progression, but 5 patients had stable disease with long-term follow-up. The 10-year overall survival, progression-free survival, and cause-specific survival were 86%, 80.5%, and 89.4%, respectively. Younger age and grade III tumors were associated with worse progression-free survival (P = .03 and .0003, respectively).

CONCLUSIONS:

Although surgery with complete resection is paramount in management of chondrosarcoma, RT is a useful adjuvant treatment and appears to offer excellent and durable local control where wide surgical resection is difficult to accomplish.

• Authors: Jayant Sastri Goda, Peter C Ferguson, Brian O'Sullivan, Charles N Catton, Anthony M Griffin, Jay S Wunder, Robert S Bell, Rita A Kandel, Peter W Chung
• Journal: Cancer (Cancer) Vol. 117 Issue 11 Pg. 2513-9 (Jun 01 2011) ISSN: 1097-0142 [Electronic] United States
• PMID: 21246520 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 American Cancer Society.

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Bone Neoplasms (diagnosis, mortality, radiotherapy, surgery)
• Chondrosarcoma (diagnosis, mortality, radiotherapy, surgery)
• Female
• Humans
• Male
• Middle Aged
• Neoplasm Grading
• Recurrence
• Salvage Therapy
• Treatment Outcome
• Tumor Burden
• Young Adult