Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, 40 Bergen St., Newark, New Jersey, 07103.
Department of Orthopaedic Surgery, Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania.
J Orthop Res. 2020 Feb;38(2):311-319. doi: 10.1002/jor.24463. Epub 2019 Sep 22.
Chondrosarcomas are rare tumors and, historically, investigation of these tumors has been limited to small series and single-institution studies. There have been no studies that evaluated the identification or comparison of differences in prognostic factors between the five known non-conventional chondrosarcoma subtypes (myxoid, juxtacortical, clear-cell, mesenchymal, and dedifferentiated). The purpose of this paper was to determine the demographic, clinical, incidence, and tumor characteristics of all five known non-conventional chondrosarcoma subtypes, determine the 1-, 5-year, and median survival differences between these subtypes, and to determine the demographic and clinical variables that are significant prognostic indicators for each chondrosarcoma subtypes. We retrospectively reviewed the SEER database for all patients with non-conventional chondrosarcoma. χ testing was used for correlations between clinical variables. Kaplan-Meier and Cox proportional hazard analysis were used to compare survival of the subtypes, and to assess the prognostic value of age group, race, sex, grade, anatomic location, and metastatic involvement. Several demographic characteristics including gender, race, age, and grade varied between chondrosarcoma subtypes. The tumor characteristics showed marked differences in presence of metastasis on presentation between the subtypes with increasing order of rate of metastasis with juxtacortical (2.1%), clear cell (5.7%), myxoid (7.6%), mesenchymal (10.6%), and the highest in dedifferentiated (19.8%). One-, 5-year, and median survival differed significantly between chondrosarcomas subtypes. The highest median survival was found in the juxtacortical subtype (97 months), followed by clear cell (79 months), myxoid (60 months), mesenchymal (33.5 months), and lowest in dedifferentiated (11 months). The only prognostic variable that was shown to significantly impact the survival of each non-conventional chondrosarcoma subtype was a metastatic disease at diagnosis (p = 0.03 to p < 0.001). Subtyping classification of chondrosarcoma should be made whenever possible, given differences in survival and prognostic factors between chondrosarcoma subtypes. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:311-319, 2020.
软骨肉瘤是一种罕见的肿瘤，在过去，对这些肿瘤的研究仅限于小系列和单机构研究。没有研究评估过五种已知非典型软骨肉瘤亚型（黏液样、皮质旁、透明细胞、间充质和去分化）之间预后因素的识别或差异比较。本文的目的是确定所有五种已知非典型软骨肉瘤亚型的人口统计学、临床、发病率和肿瘤特征，确定这些亚型之间 1 年、5 年和中位生存差异，并确定对每种软骨肉瘤亚型有重要预后意义的人口统计学和临床变量。我们回顾性地审查了 SEER 数据库中所有非典型软骨肉瘤患者的数据。χ 检验用于分析临床变量之间的相关性。Kaplan-Meier 和 Cox 比例风险分析用于比较亚型的生存情况，并评估年龄组、种族、性别、分级、解剖位置和转移参与的预后价值。包括性别、种族、年龄和分级在内的几个人口统计学特征在软骨肉瘤亚型之间存在差异。肿瘤特征在不同亚型之间表现出明显的转移存在差异，转移率依次增加，皮质旁（2.1%）、透明细胞（5.7%）、黏液样（7.6%）、间充质（10.6%），而去分化（19.8%）最高。软骨肉瘤亚型之间的 1 年、5 年和中位生存率有显著差异。皮质旁亚型的中位生存时间最长（97 个月），其次是透明细胞（79 个月）、黏液样（60 个月）、间充质（33.5 个月），而去分化的最短（11 个月）。唯一显示对每种非典型软骨肉瘤亚型的生存有显著影响的预后变量是诊断时的转移性疾病（p=0.03 至 p<0.001）。鉴于软骨肉瘤亚型之间的生存和预后因素存在差异，应尽可能进行软骨肉瘤的亚型分类。版权所有 © 2019 骨科研究协会。由 Wiley Periodicals, Inc. 出版。J Orthop Res 38:311-319, 2020.
