Background: Chondrosarcoma (CHS) is the second most common primary malignant solid bone tumor. Present management of CHS is based largely on case series from individual treatment centers. This study summarizes descriptive epidemiologic and prognostic characteristics associated with CHS patients utilizing the National Cancer Database (NCDB).
Methods: We identified 6,559 patients with CHS of the bone, joints, and/or articular cartilage in the NCDB from 2004-2015. Kaplan-Meier analyses were used to estimate 2- and 5-year survival, and median survival. Survival comparisons were made using log-rank tests.
Results: Median age at diagnosis was 53 years. 53.3% of cases were in males, and 86.4% were in white patients. 28.2% of cases were in lower limb long bones and associated joints. The most common NCDB analytic stage at presentation was stage I (60.5%). 6.4% of patients had known metastases at diagnosis. 86.6%, 7%, and 12.5% of patients received surgery, chemotherapy, and radiation, respectively. Overall probability of 5-year survival was 74.4%. Approximate 5-year survival for NCDB analytic stages I-IV was 86.2%, 53.1%, 52.4%, and 17.4%, respectively. The dedifferentiated subtype of CHS had the poorest 5-year survival (25.4%), while juxtacortical had the highest (93.4%). In 355 patients with high grade CHS, perioperative chemotherapy (33.7% 5-year survival) did not provide improved survival compared to surgery alone (51.2% 5-year survival).
Conclusions: To the best of our knowledge, this is the first NCDB study to evaluate survival by treatment type and stage in CHS, as well as to analyze epidemiologic and prognostic characteristics in all CHS subtypes. This study found CHS was most common in white patients, had a median age at diagnosis of 53 years, and was most frequently found in lower limb long bones and associated joints. The 5-year survival was much worse at stage IV compared to stages I, II, and III, as well as in dedifferentiated and mesenchymal tumor subtypes compared to conventional or other types of CHS. In high grade tumors, perioperative chemotherapy did not improve survival compared to surgery alone.
