Chondrosarcomas are tumors that predominantly consist of cartilage and account for approximately 25% of all bone sarcomas. These tumors are relatively resistant to chemo and radiotherapy. They are classified into conventional Chondrosarcomas, de-differentiated Chondrosarcoma, mesenchymal Chondrosarcoma, juxtracortical Chondrosarcoma and secondary Chondrosarcoma on the basis of histopathology and whether or not they have occurred in a previously benign cartilaginous lesion. They are further subdivided into low grade, intermediate grade and high grade Chondrosarcoma on the basis of cellularity, atypia and pleomorphism. The clinical features of Chondrosarcoma include dull aching pain especially during night time, neurological symptoms (due to nerve involvement) and pathological fractures. Diagnosis is done by imaging and histopathology. Surgery is the primary treatment and consists of complete and wide excision whenever possible. Chemo and radiotherapy has got a limited role. We conducted this retrospective study of 30 patients with Chondrosarcoma treated with uniform surgical protocol at our institution.
Materials and Methods: After obtaining approval from institutional ethical committee we conducted a retrospective study of 30 patients diagnosed with chondrosarcoma. Since Chondrosarcomas are rare we searched for the patients records diagnosed with Chondrosarcoma and details were studied from case papers and patient examination during follow up. All patients had undergone surgical treatment of primary tumors. The various surgeries done in these patients included wide excision, Tikhoff-Linberg procedures, wide chest wall resections and hemipelvectomies depending upon the site and size of the tumors. Minimum follow up was 24 months. The data was tabulated and analyzed using SPSS 16.0 version software.
Results: This study consisted of 30 patients having been diagnosed with Chondrosarcoma. There were 18 men and 12 women with a mean age of 34 years (range 18–50 years). The most common clinical features these patients presented with were swelling (76.66%) followed by pain (66.66 %), neurological symptoms due to nerve involvement (16.66%), fumigating skin lesion (13.33%) and pathological fractures (6.66%). Patients were diagnosed on the basis of Imaging (XRAY/CT /MRI) and biopsy followed by histopathological examination. Most common bones involved were femur (30%) followed by pelvic bones (26.67%) and humerus (13.33%). Various surgical procedures done included complete excision in 15 patients (50%) followed by Likhoff-Linberg procedure (20%), chest wall resections (16.66%) and hemipelvectomy (13.33%). 9 patients were lost to follow up. Out of remaining 21 patients 15 patients (50%) remained recurrence free during a follow up period of 24 months while 6 patients (20%) presented with either localized recurrence or metastasis.
Conclusions: Chondrosarcomas are heterogeneous group of tumors ranging from low-grade to very aggressive, high-grade forms. In individuals presenting with localized disease wide surgical resection represents the primary treatment modality. Recurrences and metastatic disease is difficult to manage as chemotherapy is usually ineffective. Radiotherapy may be used in such cases as a palliation therapy.