Abstract
Introduction
Dedifferentiated chondrosarcoma (D.C.) has a very poor prognosis. The efficacy of chemotherapy is still debated. Aim of this study was to evaluate the survival of patients with D.C. and to evaluate possible prognostic factors.
Methods
Between 1990 and 2006, 109 patients were treated for D.C.: 55 males and 54 females, mean age of 59.6 years. In 81 cases tumor was located in the extremities and in 28 cases in the trunk. The most frequent dedifferentiation was in osteosarcoma (53.2%) followed by spindle cell sarcoma (21%), malignant fibrous histiocytoma (13.8%), fibrosarcoma (6.4%). All patients received surgery and mostly, limb salvage with tumor resection and implantation of a megaprosthesis or allograft (65 patients). Chemotherapy was given to 43 patients.
Results
16 patients (15.5%) were Ned at a mean followup of 10 yrs, 8 patients Ned1 after treatment of relapse, 1 patient AWD at 4.7 yrs, 77 patients DWD at a mean time of 1.6 yrs, 1 patient dead for other causes and 6 patients lost to followup were excluded. The overall survival of patients was 15%. There was significant difference in survival between patientens with D.C. of the trunk and those with D.C. of the extremities (p=0.0156). There was no significant difference in survival with chemoterapy and surgery or with surgery only (p=0.1115).
Conclusion
The prognosis for patients with D.C. remains dismal. Surgery with wide margins is the principal treatment for this condition. There was no statistical evidence of any beneficial effect from chemotherapy.
