Abstract
Background: Chondrosarcoma is the second most frequent primary malignant tumor of bone. The biologic evolution of these tumors is slow, requiring long follow up for meaningful survival analysis.
Methods: The clinicopathologic profiles of 84 (41 male, 45 female/M: F, 1:1.09) chondrosarcomas of the upper limb from the Scottish Bone Tumor Registry (1940–2000) are presented.
Results: The mean age at presentation was 54.8Yrs (range 12–85yrs).The proximal humerus was the most frequent anatomical site (30.2%).21% lesions involved the scapula, and 34% small bones of the hand. Local pain was the most frequently reported initial symptom. All patients were followed up for a minimum 60 mts. Radiographically; chondrosarcomas had a characteristic appearance of bone expansion and cortical thickening. The cumulative 5 year survival was 82.5%. Local recurrence developed in19.7 % (mean 40 mts after initial presentation), and distal metastasis in 16.2%.Hand tumors rarely had metastasis. Tumor breach at time of surgery increased risk of local recurrence. Histological grade was an important factor in predictor of local recurrence and metastasis.
Discussion: Chondrosarcomas are highly diverse tumors ranging from slow growing non- metastasizing lesions to highly aggressive metastasizing sarcomas. With adequate initial surgical intervention, chondrosarcoma is primarily a local disease with a low metastatic rate. Hand lesions have best prognosis.
Correspondence should be addressed to BOOS at the Royal College of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PN
