| الوصف: |
Chondrosarcoma is the second most common primary malignant solid tumor of bone, and accounts for approximately 25% of all bone sarcomas (Bertoni et al. 2002). It is largely considered to be resistant to conventional chemotherapy and radiotherapy (Healey and Lane 1986, Campanacci 1999, Gelderbloom et al. 2008). As such, surgical resection has been the cornerstone of treatment for over 50 years (Dahlin and Henderson 1956, Healey and Lane 1986, Gelderbloom et al. 2008). However, in recent years several novel therapeutic approaches have been evaluated in experimental studies (Morioka et al. 2003, Gouin et al. 2006, Klenke et al. 2007, Delaney et al. 2009, Schrage et al. 2009, 2010). There is no consensus on prognostic factors to determine which patients have a higher risk of treatment failure and disease-related deaths, although several papers have addressed this issue (Evans et al. 1977, Pritchard et al. 1980, Gitelis et al. 1981, Bjornsson et al. 1998, Lee et al. 1999, Rizzo et al. 2001, Fiorenza et al. 2002). One reason may be that most studies have included patients treated over several decades, with no account for the different surgical criteria, indications, and methods applied over the years. Furthermore, most studies have included patients with short follow-up, despite the fact that a high rate of late recurrence and metastasis has been reported for chondrosarcoma patients compared to those with other primary bone sarcomas (Evans et al. 1977, Pritchard et al. 1980), as well as patients with rare histopathological subtypes that have a distinct biologic behavior (Lee et al. 1999, Bertoni et al. 2002, Gelderbloom et al. 2008) such as dedifferentiated chondrosarcoma, mesenchymal chondrosarcoma, and clear cell chondrosarcoma, thus reducing the validity of the results. The purpose of this long-term retrospective study was to examine a group of patients with primary central chondrosarcoma of bone who presented with localized disease and were treated with a uniform surgical protocol at our institution, in order to determine the factors that influence overall and event-free survival. We further aimed at identifying potential improvements to our therapeutic algorithm. |
