Chondrosarcoma of the chest wall: a retrospective clinical analysis.

Primary chondrosarcoma of the chest wall is uncommon, and reports of treatment from one institution are limited. Treatment of this lesion is difficult because of the anatomic location, which is in close proximity to surrounding neurovascular and visceral structures. The purpose of this study was to review the outcome of surgical resection of chondrosarcoma of the chest wall, and to delineate the prognostic factors related to local recurrence and survival. Twenty-four patients with chondrosarcoma of the chest wall were treated at our institution between 1986 and 2000. There were 14 males and 10 females, with an average age of 54 years (range, 11-76 years). Patients were observed for a minimum of 3 years or until death. The median followup was 71 months. The anatomic locations of chondrosarcoma of the chest wall were the rib in 16 patients, the ribs and sternum in two patients, the ribs and spine in three patients, and the sternum only in three patients. Histologically, 17 patients had Grade 1 disease and seven patients had Grade 2 disease. At followup, 17 patients were alive without disease, two were alive with disease, two died without disease, and three died secondary to progressive disease. The overall survival estimate at 5 years was 92%. The recurrence rate for patients with adequate surgical margins was 10%, compared with 75% for patients with inadequate margins. The 5-year survival rate for patients with adequate surgical margins was 100%, compared with 50% in patients with inadequate surgical margins. An inadequate margin of resection was associated with a significantly worse overall survival and a higher chance of having local recurrence develop.