Journal List > J Korean Orthop Assoc > v.30(3) > 1113173

Lee, Lee, and Park: Chondrosarcoma

Abstract

Recently there has been remarkable improvement in the treatment of chondrosarcoma, accompanied with the development of diagnostic tools, operative technique, replacement materials and designs, anticancer-chemotherapy and radiotherapy. In well-deferentiated chondrosarcom, wide excision is the only treatment required. Nevertheless, in dedifferentiated chondrosarcoma, anticancerchemotherapy or radiotherapy is usually recommended after the wide excision. From 1984 to 1994, 22 patients diagnosed as chondrosarcoma had been treated at Seoul National University Hospital. We analysed anatomic distributions, size, methods of treatment and their results. The avereage age was 38 years and 10 months(15 years 73 years) and the average follow-up period was 3 years and 10 months(1 year and 6 months - 10 years and 4 months). The average symptom period was 2 years and 8 months(2 months - 10 years). The chief complaints were pain(14), mass(5), pathologic fracture(1), pain & mass(1). and symptomless(l). The average size was 8.7cm(3cm - 18cm) according to the simple radiogram, and supported by CT and MRI. On pathologic classifications, there were conventional type in 19 cases and dedifferentiated type in 3 cases. According to Enneking's classification, there were 5 cases of stage IB, 2 cases of stage IIA, 14 cases of stage IIB and 1 case of stage III. The anatomical locations were femur(7), pelvis(5), tibia(3), humerus(3), scapula(2) and spine(2). Five cases were secondary chondrosarcoma, whose primary lesions were osteochondromas in all cases. Surgical treatments were performed in 21 cases, with wide margin in 14 cases(imb-salvage operation and tumor prothesis replacement were done in 7 cases, vascularized living fibula bone graft in 2 cases, autoclaved bone graft in 2 cases, excision only in 2 cases and cement filling after Huckstep instrumentation in 3 cases). Postoperative radiotherapy was given in 6 cases. Postoperative anti-cancer-chemotherapy was administered in 2 cases. On the final follow-0up, out of 14 cases who had wide excision, 11 cases were continously disease free(CDF), 2 cases were disease free(DF) and 1 case was alive with disease(AWD). And in 4 cases who had marginal excision, 1 case was CDF, 2 cases were DF and 1 case was AWD. In 3 casees who had intralesional excision, 2 cases were AWD and 1 case was died of disease. One case with initial pulmonary metastasis died 12 months after radiotherapy. With Kaplan-Meier's method, 5 years actuarial surival rate for 22 cases was 80%.

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