Influence of intralesional surgery on treatment outcome of chondrosarcoma

BACKGROUND. Intralesional (IL) surgery for chondrosarcoma is an inadequate procedure; however, sometimes it cannot be avoided. The outcome of 26 patients (PTS) who underwent IL surgery for chondrosarcoma was analyzed. METHODS. Median follow-up time was 146.5 months. Eighteen tumors were located in the axial skeleton and 8 in the extremities. The histologic grade distribution of the chondrosarcoma was: 14 Grade 1, 8 Grade 2, and 4 Grade 3. Diagnostic problems were noted in 4 of the 18 central tumors and 7 of 8 extremity tumors. RESULTS. The 20-year relapse free survival rate for the 26 PTS who underwent IL surgery was 7% and was 64% for 38 PTS who underwent wide or marginal surgery. (P = 0.03144). Conversely, the 20-year overall survival rate for the 26 PTS after IL surgery was 68% and was 66% for 38 PTS who underwent wide or marginal surgery (P = 0.2266). The overall survival rates for the PTS with tumors of histologic Grade 1 and 2 or 3 tumor was 85% and 44%, respectively (P = 0.02817). The overall survival rates for PTS with central tumors and extremital tumors were 57% and 87%, respectively (P = 0.0968). CONCLUSIONS. IL surgery for chondrosarcoma often leads to local relapse. However, local relapse does not always result in metastases and death. The prognosis for PTS after IL surgery tends to differ according to tumor grade. After local relapse, further limb salvage surgery becomes difficult and many complications may occur.