2002 CTOS Annual Meeting Oral Presentations — Surgery

DEDIFFERENTIATED CHONDROSARCOMA: UPDATED OUTCOMES WITH CURRENT TREATMENT APPROACHES AS COMPARED TO THOSE PRIOR TO 1984
[Abstract ID: 19]

Category: Surgery

Presentation: Oral

Authors: Ian Douglas Dickey¹, Sean Patrick Scully¹, Peter S. Rose¹, Laurel Littrell¹, Douglas J. Pritchard¹, Michael George Rock¹, Thomas C. Shives¹, Franklin H. Sim¹

Author Institutions: ¹Mayo Clinic, Minnesota, United States

Presenter: Ian Douglas Dickey
dickey.ian@mayo.edu

Correspondent: Ian Douglas Dickey
dickey.ian@mayo.edu
Rochester Minnesota United States 55905
Ph: 507-284-0231
Fax: 507-284-5075

Objectives: Dedifferentiated chondrosarcoma presents a very difficult clinical problem. Long term survival is known to be poor, but a large clinical series has not been analyzed in the era of modern diagnostic and treatment modalities.

Methods: A retrospective chart review of all cases of patients presenting with dedifferentiated chondrosarcoma at our institution from 1984-2000 was performed. This was done as an extension to a study published in 1986 prior to the era of modern chemotherapy.

Results: There were 42 cases in 25 men and 17 women of average age 56 (range 24-83 years). MSTS grades at presentation were 5 IIA, 27 IIB, and 10 III. Three patients underwent biopsy only, 19 had limb sacrificing, and 20 had limb sparing procedures; surgical margins were intralesional in 3, marginal in 2, and wide in 20, and radical in 14. Twenty-seven patients received adjuvant therapy (22 chemotherapy only, 2 radiotherapy only, 3 combined therapy). Median survival was 8 months; 5-year survival was 7.1%. There was no statistical difference in survival between patients who did and did not receive chemotherapy, had wide versus radical resection, or had limb sparing versus sacrificing procedures. There were no statistically significant difference between patients treated prior to 1986 and those subsequently.

Conclusions: Despite advances in diagnostic modalities, surgical treatments, and adjuvant therapies, dedifferentiated chondrosarcoma continues to carry a poor prognosis. The use of current adjuvant chemotherapy and its inherent risks and benefits remains questionable in this population.