Department of Neurosurgery, Mayo Clinic, Rochester, MN USA 55905; Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD USA 21287.
Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD USA 21287; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ USA 85013.
Spine J. 2021 Dec;21(12):2078-2096. doi: 10.1016/j.spinee.2021.04.021. Epub 2021 May 8.
Chondrosarcoma is an uncommon primary bone tumor with an estimated incidence of 0.5 per 100,000 patient-years. Primary chondrosarcoma of the mobile spine and sacrum cumulatively account for less than 20% of all cases, most .commonly causing patients to present with focal pain with or without radiculopathy, or myelopathy secondary to neural element compression. Because of the rarity, patients benefit from multidisciplinary care at academic tertiary-care centers. Current standard-of-care consists of en bloc surgical resection with negative margins; for high grade lesions adjuvant focused radiation with ≥60 gray equivalents is taking an increased role in improving local control. Prognosis is dictated by lesion grade at the time of resection. Several groups have put forth survival calculators and epidemiological evidence suggests prognosis is quite good for lesions receiving R0 resection. Future efforts will be focused on identifying potential chemotherapeutic adjuvants and refining radiation treatments as a means of improving local control.
软骨肉瘤是一种罕见的原发性骨肿瘤，估计发病率为每 10 万人年 0.5 例。活动性脊柱和骶骨的原发性软骨肉瘤累计占所有病例的不到 20%，最常见的表现为局部疼痛伴或不伴神经根病，或因神经压迫引起的脊髓病。由于其罕见性，患者受益于学术性三级护理中心的多学科护理。目前的标准治疗包括整块切除，边缘阴性；对于高级别病变，≥60 格雷等效物的辅助聚焦放疗在提高局部控制方面发挥着越来越大的作用。预后取决于切除时的病变分级。有几个小组提出了生存计算器，流行病学证据表明，对于接受 R0 切除的病变，预后相当好。未来的研究将集中于确定潜在的化疗辅助药物，并改进放疗作为提高局部控制的手段。
