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Is Chemotherapy Associated with Improved Overall Survival in Patients with Dedifferentiated Chondrosarcoma? A SEER Database Analysis.

作者信息

Cranmer Lee D, Chau Bonny, Mantilla Jose G, Loggers Elizabeth T, Pollack Seth M, Kim Teresa S, Kim Edward Y, Kane Gabrielle M, Thompson Matthew J, Harwood Jared L, Wagner Michael J

机构信息

Division of Medical Oncology, University of Washington, Seattle, WA, USA.

Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.

出版信息

Clin Orthop Relat Res. 2022 Apr 1;480(4):748-758. doi: 10.1097/CORR.0000000000002011.


DOI:10.1097/CORR.0000000000002011
PMID:34648466
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8923599/
Abstract

BACKGROUND: Dedifferentiated chondrosarcoma is a chondrosarcoma subtype associated with high rates of recurrence and a poor prognosis. Others have proposed treatment of dedifferentiated chondrosarcoma using osteosarcoma protocols, including perioperative chemotherapy. However, the rarity of this condition poses difficulties in undertaking single- institution studies of sufficient sample size. QUESTION/PURPOSE: Is perioperative chemotherapy associated with improved overall survival in patients with dedifferentiated chondrosarcoma? METHODS: We queried the Surveillance, Epidemiology, and End Results (SEER) 1973 to 2016 database for patients with a diagnosis of dedifferentiated chondrosarcoma (n = 308). As dedifferentiated chondrosarcoma was only classified as a distinct entity in SEER starting in 2000, only patients treated in 2000 and later were included. We excluded from our analyses those patients with distant disease at diagnosis, a primary site of disease other than bone or joints, and those who did not receive cancer-directed surgery. These criteria yielded 185 dedifferentiated chondrosarcoma patients for inclusion. We used Kaplan-Meier analyses and Cox proportional hazards models to assess the association of clinical, demographic, and treatment characteristics on overall survival (OS). RESULTS: After controlling for confounding variables, including age, sex, tumor size, stage, grade, location, and radiation treatment status, and after adjusting for missing data, no overall survival benefit was associated with receipt of chemotherapy in patients with dedifferentiated chondrosarcoma (hazard ratio 0.75 [95% confidence interval 0.49 to 1.12]; p = 0.16). CONCLUSION: Chemotherapy treatment of dedifferentiated chondrosarcoma was not associated with improved OS. These results must be viewed cautiously, given the limited granularity of information on chemotherapy treatment, the concerns regarding chemotherapy misclassification in SEER data, and the small sample of patients with dedifferentiated chondrosarcoma, all of which limit the power to detect a difference. Our findings are nevertheless consistent with those of prior reports in which no benefit of chemotherapy could be detected. Lack of clear benefit from perioperative chemotherapy in dedifferentiated chondrosarcoma argues that it should be used only after careful consideration, and ideally in the context of a clinical trial. LEVEL OF EVIDENCE: Level III, therapeutic study.

摘要

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引用本文的文献

[1]
Genomic Characterization of Chondrosarcoma Reveals Potential Therapeutic Targets.

JCO Precis Oncol. 2025-3

[2]
The clinical outcomes and prognostic factors of dedifferentiated central chondrosarcoma in extremities.

J Orthop Surg Res. 2024-10-3

[3]
Comparisons of clinical characteristics, treatments, and outcomes among different pathological subtypes of chondrosarcoma in the spine.

J Neurooncol. 2024-12

[4]
A Systematic Review of Adjuvant Chemotherapy in Localized Dedifferentiated Chondrosarcoma.

Curr Oncol. 2024-1-19

[5]
PRISMA-the 100 most-cited articles on chondrosarcoma recurrence: A bibliometric analysis.

Medicine (Baltimore). 2023-12-15

[6]
Dedifferentiated Chondrosarcoma from Molecular Pathology to Current Treatment and Clinical Trials.

Cancers (Basel). 2023-8-1

[7]
Primary dedifferentiated chondrosarcoma of the lung with a 4-year history of breast cancer: A case report.

World J Clin Cases. 2023-5-6

[8]
A Retrospective Multi-Institutional Cohort Analysis of Clinical Characteristics and Outcomes in Dedifferentiated Chondrosarcoma.

Cancers (Basel). 2023-5-5

[9]
The clinicopathological characteristics and prognosis of young patients with chondrosarcoma of bone.

Front Surg. 2022-9-5

[10]
Deep learning models for predicting the survival of patients with chondrosarcoma based on a surveillance, epidemiology, and end results analysis.

Front Oncol. 2022-8-22

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