a Division of Orthopaedic Surgery , Oslo University Hospital , Oslo , Norway.
b Institute of Clinical Medicine , University of Oslo , Oslo , Norway.
Acta Oncol. 2019 Mar;58(3):273-282. doi: 10.1080/0284186X.2018.1554260. Epub 2019 Jan 11.
Knowledge of chondrosarcoma (CS) of bone to date is based on institutional reports and registry publications with limits in reporting, detail and quality of data.
We have performed a retrospective search of CS of bone in the National Cancer Registry in Norway from 1990-2013, cross checked against local tumor databases with further quality control and supplementation of all data from clinical files. The time period is defined by the routine use of axial imaging in clinical practice. A total of 311 cases are included. We performed 108 pathological reviews and 223 radiological reviews. The manuscript was prepared according to the STROBE checklist for strengthening of observational studies. We performed uni-/multivariate cox analyses to define independent prognostic variables from the main cohort of central CS of bone.
The incidence of CS of bone in Norway is 2.85/million/yr. for both sexes overall, rising to 3.45/million/yr. in the last 5-year period. There is an increase in the most common central CS subtype, stronger for women than for men. Central CS had, in general 10-15% local recurrence rates, all evident by 5 years while metastasis rate increases with location and grade. Exceptions are extremity grade 1 CS which displayed no metastatic events and axial grade-3 disease with high rates (50%) of both local and metastatic relapse. Peripheral CS had limited metastatic potential (2%), but rates of local relapse (13%) continue to appear towards 10 years of follow up. Malignancy grade 3 independently predicts rate of metastasis and presence of soft tissue component predicts local recurrence, metastasis and survival.
Rates of local recurrence, metastasis and disease specific survival follow clear patterns depending on subtype, location and grade allowing better tailoring of follow-up regimes. Malignancy grade 3 and the presence of a soft tissue component independently predict behavior for central CS of bone.
目前对骨软骨肉瘤（CS）的了解主要基于机构报告和登记出版物，这些报告在报告、细节和数据质量方面存在局限性。
我们对挪威国家癌症登记处 1990 年至 2013 年期间的骨软骨肉瘤进行了回顾性搜索，与当地肿瘤数据库进行了交叉检查，并对所有临床档案中的数据进行了进一步的质量控制和补充。该时间段是由临床实践中轴向成像的常规使用定义的。共纳入 311 例患者。我们进行了 108 次病理复查和 223 次放射学复查。手稿是根据 STROBE 清单为加强观察性研究而编写的。我们进行了单变量/多变量 cox 分析，以从中央骨软骨肉瘤的主要队列中定义独立的预后变量。
挪威男女总体 CS 骨发病率为 2.85/百万/年，最后 5 年期间上升至 3.45/百万/年。最常见的中央 CS 亚型发病率上升，女性比男性更为明显。中央 CS 的局部复发率一般为 10-15%，所有病例均在 5 年内显现，而转移率随部位和分级而增加。例外情况是肢体 1 级 CS 无转移事件，轴位 3 级疾病局部和转移复发率均较高（分别为 50%）。外周 CS 的转移潜力有限（2%），但局部复发率（13%）在随访 10 年后仍持续出现。恶性程度 3 级独立预测转移率，软组织成分存在预测局部复发、转移和生存。
局部复发、转移和疾病特异性生存率的模式明确，取决于亚型、部位和分级，从而更好地调整随访方案。恶性程度 3 级和软组织成分的存在独立预测中央骨软骨肉瘤的行为。
