Treatment of patients with "high grade" extremity localized chondrosarcoma. Preliminary results

Abstract

Background. The treatment of high-grade chondrosarcoma consists of either amputation or radical surgical resection of the tumour. Introducing protocols with neo-adjuvant chemotherapy improves survival rates in patients with a high-grade chondrosarcoma. Patients and methods. In 7 years period (2000-2006), 18 patients with chondrosarcoma were treated. Female were twice more than male (12/6). Patients age varied from 14 to 73 years (mean 51). Thirteen patients (72%) had extremities localised chondrosarcoma. Eight patients (8/13), or 62% with extremity localised high-grade chondrosarcoma were subjected to Scandinavian Sarcoma Group XVI chemotherapy protocol. Six of these patients (75%) complied with the criteria for limb salvage. Results. The follow up was from 13 months to 8 years (mean 32 months). Two patients (2/8) or 25% had primarily amputated limb. After the hystopathological assessment of the resected high-grade chondrosarcoma, 6/8 patients (75%) had bad response to neoadjuvant chemotherapy. There was local recurrence in 3/8 (37%) and metastases developed in 6/8 (75%) of the operated patients with high-grade chondrosarcoma. Two of 6 patients (33%) with limb-salvage had amputations due to local recurrence. Two patients (2/8), or 25%, survived more than 5 years, and up to date they are disease-free. Conclusions. Patients with extremities localised high-grade chondrosarcoma had higher survival rates and better functional outcome, compared to those with chondrosarcoma localised centrally.