BACKGROUND: Chondrosarcoma is treated primarily by surgery. The prognosis of patients after local recurrence is not well defined. Both the survival of patients and the risk of further local relapse after surgical treatment of local recurrence have yet to be established. QUESTIONS/PURPOSES: We determined survival after local recurrence of chondrosarcoma, the rate of further local recurrences, and prognostic factors predicting survival. PATIENTS AND METHODS: We retrospectively reviewed 52 patients treated for locally recurrent conventional chondrosarcoma between 1975 and 2008. All patients had nonmetastatic disease at the time of diagnosis. There were 36 males and 16 females with a median age of 39 years (range, 16-79 years). We analyzed variables affecting overall and disease-free survival. The minimum followup was 12 months unless patients died of disease before 12 months (median, 68 months; range, 4-387 months). RESULTS: Thirty patients developed their first local recurrence in axial locations, while 22 developed recurrence in the appendicular skeleton. After local recurrence, overall survival was 74% at 5 years and 60% at 10 years. The mean number of local recurrences was three (range, 1-14). Surgical margin correlated with further local recurrence but not survival. Tumor grade, axial location, metastases, and age independently predicted survival. CONCLUSIONS: Prolonged survival of patients after local recurrence of conventional chondrosarcoma is possible, albeit with further recurrences in many patients. LEVEL OF EVIDENCE: Level IV, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
BACKGROUND:Chondrosarcoma is treated primarily by surgery. The prognosis of patients after local recurrence is not well defined. Both the survival of patients and the risk of further local relapse after surgical treatment of local recurrence have yet to be established. QUESTIONS/PURPOSES: We determined survival after local recurrence of chondrosarcoma, the rate of further local recurrences, and prognostic factors predicting survival. PATIENTS AND METHODS: We retrospectively reviewed 52 patients treated for locally recurrent conventional chondrosarcoma between 1975 and 2008. All patients had nonmetastatic disease at the time of diagnosis. There were 36 males and 16 females with a median age of 39 years (range, 16-79 years). We analyzed variables affecting overall and disease-free survival. The minimum followup was 12 months unless patients died of disease before 12 months (median, 68 months; range, 4-387 months). RESULTS: Thirty patients developed their first local recurrence in axial locations, while 22 developed recurrence in the appendicular skeleton. After local recurrence, overall survival was 74% at 5 years and 60% at 10 years. The mean number of local recurrences was three (range, 1-14). Surgical margin correlated with further local recurrence but not survival. Tumor grade, axial location, metastases, and age independently predicted survival. CONCLUSIONS: Prolonged survival of patients after local recurrence of conventional chondrosarcoma is possible, albeit with further recurrences in many patients. LEVEL OF EVIDENCE: Level IV, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
Authors: Angela Ylenia Giuffrida; Jorge E Burgueno; Leonidas G Koniaris; Juan C Gutierrez; Robert Duncan; Sean P Scully Journal: J Bone Joint Surg Am Date: 2009-05 Impact factor: 5.284