High-Risk Extracranial Chondrosarcoma Long-Term Results of Surgery and Radiation Therapy

被引:31
作者
Goda, Jayant Sastri [1 ,2 ]
Ferguson, Peter C. [3 ,4 ]
O'Sullivan, Brian [1 ,2 ]
Catton, Charles N. [1 ,2 ]
Griffin, Anthony M. [3 ]
Wunder, Jay S. [3 ,4 ]
Bell, Robert S. [3 ,4 ]
Kandel, Rita A. [5 ,6 ]
Chung, Peter W. [1 ,2 ]
机构
[1] Princess Margaret Hosp, Radiat Med Program, Toronto, ON M5G 2M9, Canada
[2] Univ Toronto, Dept Radiat Oncol, Toronto, ON, Canada
[3] Mt Sinai Hosp, Musculoskeletal Oncol Unit, Toronto, ON M5G 1X5, Canada
[4] Univ Toronto, Dept Surg, Toronto, ON, Canada
[5] Mt Sinai Hosp, Dept Pathol, Toronto, ON M5G 1X5, Canada
[6] Univ Toronto, Dept Lab Med & Pathobiol, Toronto, ON, Canada
关键词
extracranial; chondrosarcoma; radiation therapy; surgery; SOFT-TISSUE SARCOMAS; COMPONENT DEDIFFERENTIATED CHONDROSARCOMA; EXTRASKELETAL MYXOID CHONDROSARCOMA; LOW-GRADE CHONDROSARCOMAS; PROGNOSTIC-FACTORS; BONE; PELVIS; MANAGEMENT; SURVIVAL;
D O I
10.1002/cncr.25806
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUND: A study was undertaken to evaluate results of surgery and radiotherapy (RT) for high-risk extracranial chondrosarcomas. METHODS: Between 1986 and 2006, 60 patients underwent surgery and RT for extracranial high-risk chondrosarcoma. Preoperative RT (median, 50 gray [Gy]) and postoperative RT (median, 60 Gy) were used in 40% and 60% patients, respectively. Sites included pelvis/lower extremity (48%), chest wall (22%), spine/paraspinal (17%), and head and neck (13%). Overall, median tumor size was 7 cm (range, 1-22 cm), and tumor grade was I, II, and III in 22%, 64%, and 14% of cases, respectively. RESULTS: Pathologically clear surgical margins (R0) were present in 50%, microscopic positive margins (R1) in 28%, and gross positive margins (R2) in 13%, half of whom had clinically detectable residual disease; surgical margin was unknown in 8%. Median follow-up was 75 months (range, 5-230 months). The crude local control rate was 90%. Patients with R0, R1, and R2 resections had local control of 100%, 94%, and 42%, respectively. Of the 8 cases that had R2 resection, 3 experienced uncontrolled progression, but 5 patients had stable disease with long-term follow-up. The 10-year overall survival, progression-free survival, and cause-specific survival were 86%, 80.5%, and 89.4%, respectively. Younger age and grade III tumors were associated with worse progression-free survival (P=.03 and .0003, respectively). CONCLUSIONS: Although surgery with complete resection is paramount in management of chondrosarcoma, RT is a useful adjuvant treatment and appears to offer excellent and durable local control where wide surgical resection is difficult to accomplish. Cancer 2011; 117: 2513-9. (C) 2011 American Cancer Society.
引用
收藏
页码:2513 / 2519
页数:7
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