Department of Orthopedics, Kinmen Hospital, Ministry of Health and Welfare, Kinmen, Taiwan, ROC.
Institute of Medical Sciences, National Defence Medical Center, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2020 Jul;83(7):669-673. doi: 10.1097/JCMA.0000000000000315.
Chondrosarcoma is the second most common primary sarcoma of the bone. Surgery remains the gold standard for treatment due to chemotherapy and radiotherapy resistance in chondrosarcoma. The main aim of our study was to analyze patients with primary chondrosarcoma of the bone who were treated in a single tumor center. Our study team identified the prognostic factors for overall survival, metastasis-free survival, and recurrence-free survival.
From 1998 to 2012, 55 consecutive patients were treated surgically. All patients were followed for local recurrence or distant metastasis. Uni- and multivariate analyses were performed for overall, metastasis-free, and recurrence-free survival.
Local recurrence developed in 29 of the 55 patients (52.7%). Recurrence-free survival in the multivariate analysis showed a significant association with the surgical margin, and high-grade lesions were an independent factor for local recurrence. In total, 11 patients died of the disease in the study, and the 5- and 10-year survival rates were 84.4% and 78.1%, respectively. The tumor grade and local recurrence were significant factors in the univariate analysis but were insignificant in the Cox regression with time-dependent covariates (p = 0.327 and p = 0.82, respectively). The development of distant metastasis was a significant poor prognostic factor in both the uni- and multivariate analyses.
Chondrosarcoma of the bone is a disease with surgery-dependent outcomes; but, however, patients often develop subsequent recurrence of the disease. The surgical margins were statistically associated with the risk of subsequent local recurrence but did not predict survival. The development of distant metastases was an independent prognostic factor for poor survival.
软骨肉瘤是第二常见的原发性骨肉瘤。由于软骨肉瘤对化疗和放疗的耐药性，手术仍然是治疗的金标准。我们的主要目的是分析在单一肿瘤中心治疗的原发性骨软骨肉瘤患者。我们的研究小组确定了总生存率、无转移生存率和无复发生存率的预后因素。
1998 年至 2012 年，连续 55 例患者接受手术治疗。所有患者均随访局部复发或远处转移。对总生存、无转移生存和无复发生存进行单因素和多因素分析。
55 例患者中有 29 例（52.7%）发生局部复发。多因素分析显示，无复发生存与手术切缘显著相关，高级别病变是局部复发的独立因素。在研究中，共有 11 例患者死于该疾病，5 年和 10 年生存率分别为 84.4%和 78.1%。肿瘤分级和局部复发在单因素分析中是显著因素，但在 Cox 回归与时间相关协变量分析中无统计学意义（p = 0.327 和 p = 0.82）。远处转移的发展是单因素和多因素分析中预后不良的显著因素。
骨软骨肉瘤是一种依赖手术治疗的疾病；但是，患者往往会随后复发疾病。手术切缘与随后局部复发的风险有统计学关联，但不能预测生存。远处转移的发生是预后不良的独立预后因素。
