Predicting survival outcomes in dedifferentiated chondrosarcoma: a prognostic factor analysis from a National Registry
Introduction: Dedifferentiated chondrosarcoma (DDCS) is a high-grade subtype of chondrosarcoma with a poor prognosis. Treatment for localized DDCS generally involves wide resection; the effectiveness of adjuvant radiotherapy and chemotherapy is questionable. This research was designed to find progno...
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EDP Sciences
2025-01-01
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| author | Masunaga Tomoya Tsukamoto Shinji Honoki Kanya Fujii Hiromasa Kido Akira Akahane Manabu Tanaka Yasuhito Mavrogenis Andreas F. Errani Costantino Kawai Akira |
| author_facet | Masunaga Tomoya Tsukamoto Shinji Honoki Kanya Fujii Hiromasa Kido Akira Akahane Manabu Tanaka Yasuhito Mavrogenis Andreas F. Errani Costantino Kawai Akira |
| author_sort | Masunaga Tomoya |
| collection | DOAJ |
| description | Introduction: Dedifferentiated chondrosarcoma (DDCS) is a high-grade subtype of chondrosarcoma with a poor prognosis. Treatment for localized DDCS generally involves wide resection; the effectiveness of adjuvant radiotherapy and chemotherapy is questionable. This research was designed to find prognostic factors for DDCS and evaluate the impact of adjuvant therapies on localized cases. Methods: One hundred thirty-two patients with DDCS diagnosed by pathology in the period 2006 to 2022 were identified in the Japanese National Bone and Soft Tissue Tumor Registry database and were retrospectively analyzed. Results: Patients with distant metastases at diagnosis (n = 34) had significantly poorer survival than those without metastases (n = 98), with a 5-year disease-specific survival (DSS) of 9.7% vs. 37.1% (P < 0.0001). For patients without distant metastasis at diagnosis, uni- and multivariate analysis showed that R1 or R2 surgical margin was an independent risk factor linked with unfavorable local recurrence (hazard ratio [HR] 3.39 [95% CI: 1.35–8.52]; P = 0.010). Adjuvant radiotherapy was not associated with local recurrence (HR 2.41 [95% CI: 0.87–6.64]; P = 0.090). Larger size (HR 1.13 [95% CI: 1.06–1.19]; P < 0.001) and no surgery (HR 3.87 [95% CI: 1.61–9.28]; P = 0.002) were independent risk factors for unfavorable DSS. Previous surgery (HR 0.19 [95% CI: 0.04–0.84]; P = 0.028) and adjuvant chemotherapy (HR 0.36 [95% CI: 0.16–0.77]; P = 0.009) were independent risk factors for favorable DSS. Discussion: Survival may have been improved by chemotherapy, but the effect of adjuvant radiotherapy in controlling the local spread of the tumor appears to have been limited in DDCS cases that were localized. |
| format | Article |
| id | doaj-art-4a38642fe0c246f6affbeba52016f7f5 |
| institution | DOAJ |
| issn | 2426-8887 |
| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-4a38642fe0c246f6affbeba52016f7f52025-08-20T03:05:55ZengEDP SciencesSICOT-J2426-88872025-01-01111610.1051/sicotj/2025011sicotj250012Predicting survival outcomes in dedifferentiated chondrosarcoma: a prognostic factor analysis from a National RegistryMasunaga Tomoya0Tsukamoto Shinji1https://orcid.org/0000-0002-8419-2008Honoki Kanya2https://orcid.org/0000-0001-6763-0478Fujii Hiromasa3Kido Akira4https://orcid.org/0000-0002-7658-3690Akahane Manabu5https://orcid.org/0000-0003-4184-2151Tanaka Yasuhito6https://orcid.org/0000-0002-2300-611XMavrogenis Andreas F.7https://orcid.org/0000-0003-0807-0719Errani Costantino8https://orcid.org/0000-0002-4504-2867Kawai Akira9Department of Orthopaedic Surgery, Nara Medical UniversityDepartment of Orthopaedic Surgery, Nara Medical UniversityDepartment of Orthopaedic Surgery, Nara Medical UniversityDepartment of Orthopaedic Surgery, Nara Medical UniversityDepartment of Rehabilitation Medicine, Nara Medical UniversityDepartment of Health and Welfare Services, National Institute of Public HealthDepartment of Orthopaedic Surgery, Nara Medical UniversityFirst Department of Orthopaedics, National and Kapodistrian University of Athens, School of MedicineDepartment of Orthopaedic Oncology, IRCCS Istituto Ortopedico RizzoliDivision of Musculoskeletal Oncology, National Cancer Center HospitalIntroduction: Dedifferentiated chondrosarcoma (DDCS) is a high-grade subtype of chondrosarcoma with a poor prognosis. Treatment for localized DDCS generally involves wide resection; the effectiveness of adjuvant radiotherapy and chemotherapy is questionable. This research was designed to find prognostic factors for DDCS and evaluate the impact of adjuvant therapies on localized cases. Methods: One hundred thirty-two patients with DDCS diagnosed by pathology in the period 2006 to 2022 were identified in the Japanese National Bone and Soft Tissue Tumor Registry database and were retrospectively analyzed. Results: Patients with distant metastases at diagnosis (n = 34) had significantly poorer survival than those without metastases (n = 98), with a 5-year disease-specific survival (DSS) of 9.7% vs. 37.1% (P < 0.0001). For patients without distant metastasis at diagnosis, uni- and multivariate analysis showed that R1 or R2 surgical margin was an independent risk factor linked with unfavorable local recurrence (hazard ratio [HR] 3.39 [95% CI: 1.35–8.52]; P = 0.010). Adjuvant radiotherapy was not associated with local recurrence (HR 2.41 [95% CI: 0.87–6.64]; P = 0.090). Larger size (HR 1.13 [95% CI: 1.06–1.19]; P < 0.001) and no surgery (HR 3.87 [95% CI: 1.61–9.28]; P = 0.002) were independent risk factors for unfavorable DSS. Previous surgery (HR 0.19 [95% CI: 0.04–0.84]; P = 0.028) and adjuvant chemotherapy (HR 0.36 [95% CI: 0.16–0.77]; P = 0.009) were independent risk factors for favorable DSS. Discussion: Survival may have been improved by chemotherapy, but the effect of adjuvant radiotherapy in controlling the local spread of the tumor appears to have been limited in DDCS cases that were localized.https://www.sicot-j.org/articles/sicotj/full_html/2025/01/sicotj250012/sicotj250012.htmldedifferentiated chondrosarcomaadjuvantchemotherapysurgeryradiotherapy |
| spellingShingle | Masunaga Tomoya Tsukamoto Shinji Honoki Kanya Fujii Hiromasa Kido Akira Akahane Manabu Tanaka Yasuhito Mavrogenis Andreas F. Errani Costantino Kawai Akira Predicting survival outcomes in dedifferentiated chondrosarcoma: a prognostic factor analysis from a National Registry SICOT-J dedifferentiated chondrosarcoma adjuvant chemotherapy surgery radiotherapy |
| title | Predicting survival outcomes in dedifferentiated chondrosarcoma: a prognostic factor analysis from a National Registry |
| title_full | Predicting survival outcomes in dedifferentiated chondrosarcoma: a prognostic factor analysis from a National Registry |
| title_fullStr | Predicting survival outcomes in dedifferentiated chondrosarcoma: a prognostic factor analysis from a National Registry |
| title_full_unstemmed | Predicting survival outcomes in dedifferentiated chondrosarcoma: a prognostic factor analysis from a National Registry |
| title_short | Predicting survival outcomes in dedifferentiated chondrosarcoma: a prognostic factor analysis from a National Registry |
| title_sort | predicting survival outcomes in dedifferentiated chondrosarcoma a prognostic factor analysis from a national registry |
| topic | dedifferentiated chondrosarcoma adjuvant chemotherapy surgery radiotherapy |
| url | https://www.sicot-j.org/articles/sicotj/full_html/2025/01/sicotj250012/sicotj250012.html |
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