The Journal of Bone and Joint Surgery (American). 2009;91:1063-1072.
doi:10.2106/JBJS.H.00416
© 2009 The Journal of Bone and Joint Surgery, Inc.
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Chondrosarcoma in the United States (1973 to 2003): An Analysis of 2890 Cases from the SEER Database

Angela Ylenia Giuffrida, MD1, Jorge E. Burgueno, MD1, Leonidas G. Koniaris, MD2, Juan C. Gutierrez, MD2, Robert Duncan, PhD3 and Sean P. Scully, MD, PhD1

1 Department of Orthopaedics, Sylvester Cancer Center, University of Miami Miller School of Medicine, 1400 N.W. 12th Avenue, Miami, FL 33136. E-mail address for S.P. Scully: sscully{at}med.miami.edu
2 Division of Surgical Oncology, DeWitt Daughtry Family Department of Surgery, 3550 Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1475 N.W. 12th Avenue, Miami, FL 33136
3 Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, 1475 N.W. 12th Avenue, Miami, FL 33136

Investigation performed at the University of Miami, Miami, Florida

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

A commentary is available with the electronic versions of this article, on our web site (www.jbjs.org) and on our quarterly CD-ROM/DVD (call our subscription department, at 781-449-9780, to order the CD-ROM or DVD).

Background: Current demographic, prognostic, and outcomes data on the diagnosis and treatment of chondrosarcoma have been based on case series reported by individual treatment centers. The SEER (Surveillance, Epidemiology and End Results) database is a validated national epidemiological surveillance system and cancer registry that has been used extensively to evaluate treatment outcomes in cases of malignancy. The purpose of the present study was to use this database to identify demographic and prognostic characteristics of chondrosarcoma and to describe the natural history following the treatment of this rare disease in the United States over the last thirty years.

Methods: Two thousand eight hundred and ninety patients with chondrosarcoma were identified in the SEER database, and information regarding the demographic and clinical characteristics of the patients, the histological features and grade of the tumors, the location and size of the tumors, the surgical stage at the time of diagnosis, the use of surgery and radiation treatment, and survival were extracted.

Results: Comparison of the overall and disease-specific survival rates revealed that patients who survived for ten years were more likely to die of events that were unrelated to chondrosarcoma. The disease-specific survival rate leveled off at ten years of follow-up. Univariate analysis revealed that female sex, a low histological grade, and local surgical stage were associated with a significant disease-specific survival benefit. An age of fifty years or less and an appendicular location of the tumor were associated with a significant overall survival benefit. On multivariate analysis, only grade and stage had significant association with disease-specific survival. On the basis of a comparison of survival rates according to the decade of diagnosis, it appears that there has been no significant improvement in survival over the last thirty years.

Conclusions: Only grade and stage are independent prognostic factors for survival in cases of chondrosarcoma. Current treatment algorithms have not improved the survival rates of patients with chondrosarcoma over the past thirty years. Routine patient surveillance following treatment should be extended to ten years of follow-up.

Level of Evidence: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.


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