Ivar Hompland1, Stefano Ferrari2, Stefan Bielack3, Emanuela Palmerini2, Kirsten S Hall4, Pierro Picci5, Stefanie Hecker-Nolting3, Davide M Donati6, Claudia Blattmann3, Bodil Bjerkehagen7, Eric Staals6, Leo Kager8, Marco Gambarotti9, Thomas Kühne10, Mikael Eriksson11, Virginia Ferraresi12, Matthias Kevric3, Roberto Biagini13, Daniel Baumhoer14, Otte Brosjø15, Alessandro Comandone16, Rudolf Schwarz17, Rossella Bertulli18, Torsten Kessler19, Lina Hansson20, Gaetano Apice21, Björn-N Heydrich22, Elisabetta Setola2, Anne Flörcken23, Pietro Ruggieri24, Fatime Krasniqi25, Gerda Hofmann-Wackersreuther26, Paolo Casali27, Peter Reichardt28, Sigbjørn Smeland4. 1. Department of Oncology, Oslo University Hospital, Oslo, Norway. Electronic address: ivahom@ous-hf.no. 2. Chemotherapy Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy. 3. Klinikum Stuttgart- Olgahospital, Center for Pediatric, Adolescent and Womeńs Medicine, Pediatrics 5 (Hematology, Oncology and Immunology), Stuttgart, Germany. 4. Department of Oncology, Oslo University Hospital, Oslo, Norway. 5. Italian Sarcoma Group, Bologna, Italy. 6. Orthopaedic Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy. 7. Department of Pathology, Oslo University Hospital, Oslo, Norway. 8. St. Anna Children's Hospital, Department of Pediatrics, Medical University of Vienna, Austria. 9. Department of Pathology, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy. 10. University Children's Hospital Basel, Oncology/Hematology, Basel, Switzerland. 11. Department of Oncology, Skane University Hospital and Lund University, Lund, Sweden. 12. IRCCS Regina Elena National Cancer Institute-SSD Sarcomi e Tumori Rari, Rome, Italy. 13. Department of Orthopaedic Oncology, IRCCS Regina Elena National Cancer Institute, Rome Italy. 14. Bone Tumor Reference Center at the Institute of Medical Genetics and Pathology, University Hospital of Basel, University of Basel, Basel, Switzerland. 15. Department of Orthopedics, Karolinska University Hospital, Stockholm, Sweden. 16. Division of Medical Oncology, Humanitas Gradenigo Hospital, Turin, Italy. 17. Department of Radiation Oncology, University Medical Center Eppendorf, Hamburg, Germany. 18. Medical Oncology Unit 2, Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori Di Milano, Milan, Italy. 19. University Clinic Muenster, Medical Clinic A, Hematology/Oncology, Muenster, Germany. 20. Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden. 21. Experimental Oncology of Sarcoma and Rare Tumor, National Cancer Institut, Naples, Italy. 22. Med. Klink II, University Hospital Schleswig-Holstein - Campus Kiel, Kiel, Germany. 23. Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Berlin, Germany. 24. Department of Orthopaedics and Orthopaedic Oncology, University of Padova, Padova, Italy. 25. Universitätsspital Basel, Medizinische Onkologie, Basel, Switzerland. 26. Department of Hematology and Medical Oncology, Paracelsus Medical University, Klinikum Nuernberg, Germany. 27. 1 Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy. 28. Helios Klinikum Berlin-Buch, Berlin, Germany.
Abstract
INTRODUCTION: The role of chemotherapy for patients with dedifferentiated chondrosarcoma (DDCS) is still under discussion. Here, we present the outcome in patients with DDCS treated with intensive chemotherapy from the EUROpean Bone Over 40 Sarcoma Study. MATERIALS AND METHODS: The chemotherapy regimen included doxorubicin, ifosfamide and cisplatin. Postoperative methotrexate was added in case of poor histological response. Toxicity was graded based on the National Cancer Institute expanded common toxicity criteria, version 2.0, and survival was analysed using Kaplan-Meier curves, log-rank tests and univariate Cox regression models. RESULTS: Fifty-seven patients with DDCS (localised, 34 [60%]; metastatic, 23 [40%]) aged 42-65 years were included. Surgical complete remission (SCR) was achieved in 36 (63%) patients. The median overall survival (OS) was 24 months (95% confidence interval, 22-25), and the 5-year OS was 39%. Patients with extremity localisation had a 5-year OS of 49% compared with 29% in patients with a central tumour (P = 0.08). Patients with localised disease had a 5-year OS of 46%, whereas patients with metastatic disease had a 5-year OS of 29% (P = 0.12). Patients in SCR had a 5-year OS of 49%, whereas patients not in SCR had a 5-year OS of 23% (P = 0.004). Chemotherapy toxicity was considerable but manageable. There was no treatment-related death, and 39 (70%) patients received ≥6 cycles of the planned nine chemotherapy cycles. CONCLUSIONS: Adding intensive chemotherapy to surgery for treatment of DDCS is feasible and shows favourable survival data compared with previous reports. With the limitations of data from a non-controlled trial, we conclude that chemotherapy could be considered in the management of patients aged >40 years.
INTRODUCTION: The role of chemotherapy for patients with dedifferentiated chondrosarcoma (DDCS) is still under discussion. Here, we present the outcome in patients with DDCS treated with intensive chemotherapy from the EUROpean Bone Over 40 Sarcoma Study. MATERIALS AND METHODS: The chemotherapy regimen included doxorubicin, ifosfamide and cisplatin. Postoperative methotrexate was added in case of poor histological response. Toxicity was graded based on the National Cancer Institute expanded common toxicity criteria, version 2.0, and survival was analysed using Kaplan-Meier curves, log-rank tests and univariate Cox regression models. RESULTS: Fifty-seven patients with DDCS (localised, 34 [60%]; metastatic, 23 [40%]) aged 42-65 years were included. Surgical complete remission (SCR) was achieved in 36 (63%) patients. The median overall survival (OS) was 24 months (95% confidence interval, 22-25), and the 5-year OS was 39%. Patients with extremity localisation had a 5-year OS of 49% compared with 29% in patients with a central tumour (P = 0.08). Patients with localised disease had a 5-year OS of 46%, whereas patients with metastatic disease had a 5-year OS of 29% (P = 0.12). Patients in SCR had a 5-year OS of 49%, whereas patients not in SCR had a 5-year OS of 23% (P = 0.004). Chemotherapy toxicity was considerable but manageable. There was no treatment-related death, and 39 (70%) patients received ≥6 cycles of the planned nine chemotherapy cycles. CONCLUSIONS: Adding intensive chemotherapy to surgery for treatment of DDCS is feasible and shows favourable survival data compared with previous reports. With the limitations of data from a non-controlled trial, we conclude that chemotherapy could be considered in the management of patients aged >40 years.
Authors: Lee D Cranmer; Bonny Chau; Jose G Mantilla; Elizabeth T Loggers; Seth M Pollack; Teresa S Kim; Edward Y Kim; Gabrielle M Kane; Matthew J Thompson; Jared L Harwood; Michael J Wagner Journal: Clin Orthop Relat Res Date: 2022-04-01 Impact factor: 4.755
Authors: Marcos R Gonzalez; Mayte Bryce-Alberti; Arianna Portmann-Baracco; Maria L Inchaustegui; Samy Castillo-Flores; Juan Pretell-Mazzini Journal: J Bone Oncol Date: 2022-10-08 Impact factor: 4.491