J Korean Orthop Assoc.
1994 Jun;29(3):1072-1079. 10.4055/jkoa.1994.29.3.1072.
Surgical Treatment of Chondrosarcoma
- KMID: 2423177
- DOI: http://doi.org/10.4055/jkoa.1994.29.3.1072
Abstract
- Chondrosarocoma is a malignant, relatively slow-growing cartilaginous tumor that generally has a long natural history. From Feb. 1986 to Jan. 1993, 29 cases of chondrosarcoma were registered in the Department of Orthopedic Suergery of Korea Cancer Center Hospital. We reviewed 23 cases of chondrosarcoma which were treated surgically, aimed at curative procedure. Fourteen patients were male and 9 female. The average age at the time of diagnosis was 31.9(17-59) years. The pelvis was the most frequent site(7 patients) followed by femur(6), scapula(4), tibia(2), and each one case of spine, rib, humerus, and finger. The Enneking s surgical stage was II B (18 cases), II A (1), I B (3) or I A (1). The histological grades were as follows : 4 cases of grade 1; 3 grade 2 and 16 grade 3. Local resection with or without reconstruction were done for 20 cases and amputation or disarticulation 3. Chemotherapy was done in four cases and was not effective. The average follow-up period was 34.2(9-81) months. As complications, local recurrence occurred in 4(17.3%) cases, infection 2(8.7%), fracture 1(4.3%), lymphedema 1 and rediation necrosis of soft tissue 1, Distant metastasis occurred in 7(30.0%) cases: 6 cases to lung and 1 to brain. At final follow up 15 cases were continuous disease free, 3 alive with disease, 4 died of disease and 1 no evidence of disease. The Kaplan-Meier's estimated 5-year actuarial survival rate of total 23 cases was 66. 9%. Seven cases with histopathologic grade less than 2 showed 100% of 5 year actuarial survival rate, even one case is alive with disease at final follow up of 62 months. Fifteen cases of surgical stage II B with histopathologic grade 3 had 55.4% of 5 year actuarial survival rate: ten cases with wide surgical margin 87.5%o five cases with intralesional or marginal surgical margin 25%. Early surgical excision of chondrosarcoma with enough wide surgical margin can prevent local recurrence and metastasis.
