Background

Histological grade has been regarded as the most important prognostic factor in conventional central chondrosarcoma. To evaluate whether the presence of an extraosseous tumour component is associated with a decreased metastasis-free survival or disease-specific survival and alternatively to develop a simple prognostic and clinical decision-making tool.

Material and methods

We searched two prospectively maintained international sarcoma centre databases for primary non metastatic central conventional chondrosarcomas of all grades in pelvis, scapula or long bone location, undergoing curative treatment, diagnosed between 2000 and 2020. Pre-treatment MRI scans were reviewed for the presence of an extraosseous mass. The metastasis-free survival (MFS) and disease-specific survival (DSS) were estimated by the Kaplan-Meier method from surgery to event, death or last follow-up.

Results

336 patients were identified between 2000 and 2020, undergoing surgical treatment for conventional central chondrosarcoma. 111 patients (33 %) had grade 1 tumours, 149 patients (44 %) had grade 2, and 76 patient (23 %) had grade 3 chondrosarcomas determined as the highest grade in the final resected specimen. An extraosseous soft tissue component was more frequent in higher grade tumours (p < 0.001) and present in 200 cases (60 %). None of the patients with an intraosseous tumour developed metastases or died of the disease. For patients with extraosseous tumour component, MFS was 92 % (95 % CI, 96–100) at 2-years and 74 % (95 % CI, 67–81) at 10-years and DSS was 91 % (95 % CI, 87–95) at 2-years and 75 % (95 % CI, 68–82) at 10-years. The MFS and DSS was significantly different (p < 0.001) for those patients with or without an extraosseous tumour component, irrespective of grade or anatomical location.

Discussion

The results of this study has shown that the metastatic potential of intraosseous conventional central chondrosarcoma is negligible. The presence of an extraosseous soft tissue component may be used for prognostication and to guide treatment pathways for patients with central cartilage tumours.

中文翻译：

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无论骨盆、肩胛骨和长骨位置的级别如何，骨内传统中央软骨肉瘤都不会转移

背景

组织学分级被认为是传统中心性软骨肉瘤最重要的预后因素。评估骨外肿瘤成分的存在是否与无转移生存率或疾病特异性生存率降低相关，或者开发一种简单的预后和临床决策工具。

材料与方法

我们检索了两个前瞻性维护的国际肉瘤中心数据库，查找 2000 年至 2020 年间诊断的、正在接受治疗的骨盆、肩胛骨或长骨位置所有级别的原发性非转移性中央传统软骨肉瘤。骨外肿块。通过Kaplan-Meier法估计从手术到事件、死亡或最后一次随访的无转移生存期（MFS）和疾病特异性生存期（DSS）。

结果

2000 年至 2020 年间，共有 336 名患者接受传统中央软骨肉瘤手术治疗。111 名患者 (33%) 患有 1 级肿瘤，149 名患者 (44%) 患有 2 级肿瘤，76 名患者 (23%) 患有 3 级软骨肉瘤，确定为最终切除标本中的最高级别。骨外软组织成分在级别较高的肿瘤中更为常见 (p < 0.001)，存在于 200 例 (60%) 病例中。没有骨内肿瘤患者发生转移或死于该疾病。对于骨外肿瘤患者，2 年时的 MFS 为 92%（95% CI，96-100），10 年时为 74%（95% CI，67-81），DSS 为 91%（95% CI，96-100）。 2 年时为 87–95)，10 年时为 75% (95% CI，68–82)。对于有或没有骨外肿瘤成分的患者，无论级别或解剖位置如何，MFS 和 DSS 均显着不同 (p < 0.001)。

讨论

这项研究的结果表明，骨内传统中央软骨肉瘤的转移潜力可以忽略不计。骨外软组织成分的存在可用于预测并指导中央软骨肿瘤患者的治疗途径。