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Trovarelli G, Sbaraglia M, Angelini A, Bellan E, Pala E, Belluzzi E, Pozzuoli A, Borga C, Dei Tos AP, Ruggieri P. Are IDH1 R132 Mutations Associated With Poor Prognosis in Patients With Chondrosarcoma of the Bone? Clin Orthop Relat Res 2024; 482:00003086-990000000-01457. [PMID: 38170705 PMCID: PMC11124741 DOI: 10.1097/corr.0000000000002960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 12/01/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Because chondrosarcomas vary widely in their behavior, and because anticipating their behavior based on histology alone can be challenging, genetic markers represent an appealing area of inquiry that may help us refine our prognostic approaches. Isocitrate dehydrogenase (IDH) mutations are involved in the pathogenesis of a variety of neoplasms, and recently, IDH1/2 mutations have been found in the tissue of benign cartilage tumors as well as in conventional chondrosarcomas and highly aggressive dedifferentiated chondrosarcomas. However, their association with patient survival is still controversial. QUESTIONS/PURPOSES (1) What proportion of patients with chondrosarcomas carry IDH mutations, and which IDH mutations can be found? (2) Are any specific IDH mutations associated with poorer overall survival, metastasis-free survival, or local recurrence-free survival? METHODS Between April 2017 and December 2022, we treated 74 patients for atypical cartilaginous tumors or chondrosarcomas in a musculoskeletal tumor referral center. Patients were considered potentially eligible for the present study if the histologic diagnosis was confirmed by two expert soft tissue and bone pathologists following the current WHO classification, complete preoperative imaging and follow-up data were available, surgical excision was performed by sarcoma orthopaedic surgeons directed by a team leader, and the minimum follow-up was 2 years after surgical treatment unless the patient died. Data including sex, age, diagnosis, grade, type of operation, local recurrence, metastasis, and oncologic follow-up were recorded. Forty-one patients (55%) were eligible for the study. For each patient, DNA was extracted and quantified from paraffin-embedded sections of tumor tissue, and the mutational status of IDH1 (codons 105 and 132) and IDH2 (codons 140 and 172) genes was assessed. Of those, 56% (23 of 41) of patients had adequate DNA for analysis of IDH mutations: 10 male and 13 female patients, with a median age of 59 years (range 15 to 98 years). There were 22 conventional chondrosarcomas (8 atypical cartilaginous tumors, 11 Grade 2, and 3 Grade 3) and 1 dedifferentiated chondrosarcoma. Stage was IA in 3 patients, IB in 5, IIA in 1, IIB in 13, and III in 1, according to the Musculoskeletal Tumor Society classification. At a median follow-up of 3.5 years (range 4 months to 5.6 years), 14 patients were disease-free, 2 were alive with disease, and 7 died (3 within 2 years from surgery). Eight patients had metastases, and 7 developed local recurrence. We determined the proportion of patients who carried IDH mutations, and compared patients with and without those mutations in terms of overall survival, metastasis-free survival, and local recurrence-free survival using Kaplan-Meier curves. RESULTS Six patients showed wild-type IDH genes, and 17 had IDH mutations (12 had IDH1 R132, 3 had IDH1 G105, and 2 had IDH2 R172). Overall survival at 2 years using the Kaplan-Meier estimator was lower in patients with an IDH mutation than in those with the wild-type gene (75% [95% confidence interval 50% to 99%] versus 100% [95% CI 100% to 100%]; p = 0.002). Two-year metastasis-free survival was also lower in patients with an IDH mutation than in those with the wild-type gene (33% [95% CI 7% to 60%] versus 100% [95% CI 100% to 100%]; p = 0.001), as was 2-year local recurrence-free survival (70% [95% CI 42% to 98%] versus 100% [95% CI 100% to 100%]; p = 0.02). CONCLUSION We found that IDH1 R132 mutations were negatively associated with the prognosis of patients with bone chondrosarcomas. Nevertheless, more extensive studies (such as multicenter international studies) are needed and advisable to confirm our observations in this preliminary small series. Moreover, evaluating mutational status in fresh samples instead of in paraffin-embedded sections could help to increase the number of patients with adequate DNA for analysis. If our findings will be confirmed, the evaluation of IDH mutational status in biopsy samples or resection specimens could be considered when stratifying patients, highlighting those who may benefit from more aggressive treatment (such as adjuvant chemotherapy) or closer follow-up. LEVEL OF EVIDENCE Level III, prognostic study.
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Affiliation(s)
- Giulia Trovarelli
- Department of Orthopedics and Orthopedic Oncology, University of Padua, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology of University of Padova, Padua, Italy
| | - Marta Sbaraglia
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua School of Medicine, Padua, Italy
| | - Andrea Angelini
- Department of Orthopedics and Orthopedic Oncology, University of Padua, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology of University of Padova, Padua, Italy
| | - Elena Bellan
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua School of Medicine, Padua, Italy
| | - Elisa Pala
- Department of Orthopedics and Orthopedic Oncology, University of Padua, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology of University of Padova, Padua, Italy
| | - Elisa Belluzzi
- Department of Orthopedics and Orthopedic Oncology, University of Padua, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology of University of Padova, Padua, Italy
| | - Assunta Pozzuoli
- Department of Orthopedics and Orthopedic Oncology, University of Padua, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology of University of Padova, Padua, Italy
| | - Chiara Borga
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua School of Medicine, Padua, Italy
| | - Angelo Paolo Dei Tos
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua School of Medicine, Padua, Italy
| | - Pietro Ruggieri
- Department of Orthopedics and Orthopedic Oncology, University of Padua, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology of University of Padova, Padua, Italy
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Wei J, Lu S, Liu W, Liu H, Feng L, Tao Y, Pu Z, Liu Q, Hu Z, Wang H, Li W, Kang W, Yin C, Feng Z. A machine learning-based model for clinical prediction of distal metastasis in chondrosarcoma: a multicenter, retrospective study. PeerJ 2023; 11:e16485. [PMID: 38130920 PMCID: PMC10734410 DOI: 10.7717/peerj.16485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/27/2023] [Indexed: 12/23/2023] Open
Abstract
Background The occurrence of distant metastases (DM) limits the overall survival (OS) of patients with chondrosarcoma (CS). Early diagnosis and treatment of CS remains a great challenge in clinical practice. The aim of this study was to investigate metastatic factors and develop a risk stratification model for clinicians' decision-making. Methods Six machine learning (ML) algorithms, including logistic regression (LR), plain Bayesian classifier (NBC), decision tree (DT), random forest (RF), gradient boosting machine (GBM) and extreme gradient boosting (XGBoost). A 10-fold cross-validation was performed for each model separately, multicenter data was used as external validation, and the best (highest AUC) model was selected to build the network calculator. Results A total of 1,385 patients met the inclusion criteria, including 82 (5.9%) patients with metastatic CS. Multivariate logistic regression analysis showed that the risk of DM was significantly higher in patients with higher pathologic grades, T-stage, N-stage, and non-left primary lesions, as well as those who did not receive surgery and chemotherapy. The AUC of the six ML algorithms for predicting DM ranged from 0.911-0.985, with the extreme gradient enhancement algorithm (XGBoost) having the highest AUC. Therefore, we used the XGB model and uploaded the results to an online risk calculator for estimating DM risk. Conclusions In this study, combined with adequate SEER case database and external validation with data from multicenter institutions in different geographic regions, we confirmed that CS, T, N, laterality, and grading of surgery and chemotherapy were independent risk factors for DM. Based on the easily available clinical risk factors, machine learning algorithms built the XGB model that predicts the best outcome for DM. An online risk calculator helps simplify the patient assessment process and provides decision guidance for precision medicine and long-term cancer surveillance, which contributes to the interpretability of the model.
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Affiliation(s)
- Jihu Wei
- Faculty of Postgraduate, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Shijin Lu
- Centre for Translational Medical Research in Integrative Chinese and Western Medicine, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Wencai Liu
- Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - He Liu
- Faculty of Postgraduate, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Lin Feng
- Faculty of Postgraduate, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Yizi Tao
- Faculty of Postgraduate, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Zhanglin Pu
- Faculty of Postgraduate, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Qiang Liu
- Orthopedic Department, Xianyang Central Hospital, Xianyang, Shannxi, China
| | - Zhaohui Hu
- Department of Spine Surgery, Liuzhou People’s Hospital, Liuzhou, Guangxi, China
| | - Haosheng Wang
- Department of Orthopaedics, The Second Hospital of Jilin University, Changchun, China
| | - Wenle Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xianmen, Fujian, China
| | - Wei Kang
- Faculty of Medicine, Macau University of Science and Technology, Macau, China
- Department of Mathematics, Physics and Interdisciplinary Studies, Guangzhou Laboratory (Bioland Laboratory, Guangzhou Regenerative Medicine and Health Guangdong Laboratory), Guangzhou, China
| | - Chengliang Yin
- Faculty of Medicine, Macau University of Science and Technology, Macau, China
| | - Zhe Feng
- Joint & Sports Medicine Surgery Division, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, Guangxi, China
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Ma R, Heim T, Schoedel K, Weiss KR. Patient-Derived Spheroid Culture Models Are Better Than Monolayer Models in Chondrosarcoma Research. RESEARCH SQUARE 2023:rs.3.rs-3728259. [PMID: 38168175 PMCID: PMC10760310 DOI: 10.21203/rs.3.rs-3728259/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Purpose Chondrosarcoma (CSA) are mesenchymal tissue-derived bone tumors. CSA mainly occurs in older people. CSA has demonstrated resistance to chemotherapy and radiation; complete surgical removal with negative margins is the only treatment option. In the case of metastatic CSA, the chance of survival is meager. Since the conventional two-dimensional cell culture models failed to retain tumor characteristics, developing preclinical models mimicking the disease with the highest fidelity is paramount for personalized treatments. Methods In this study, we established spherical cultured cells as new models for CSA. First, we demonstrated that CSA cells could form spheroids when cultured in ultra-low attachment plates. Next, tissue samples from CSA patients were collected and processed into primary cells, which were subsequently cultured as primary spheroids. The growth rate of primary spheroids was monitored and the histology of mature spheroids were characterized. These primary spheroids were used in drug susceptibility studies where traditional doxorubicin therapy and our novel disulfiram-copper therapy were tested. Results Compared with conventional monolayer cultures, spheroids better recapitulated the features of the in vivo tumor in the aspect of the formation of extracellular matrix. In the drug susceptibility study, spheroids demonstrated high resistance to the classic therapies, suggesting that monolayer cultures may give false positive results. Therefore, using spheroids for drug research and development in the CSA field should provide more accurate results. Conclusion In summary, our study of primary CSA spheroids brought new insight into their chemoresistance and demonstrated its potential for personalized treatment of CSA in clinical medicine.
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Affiliation(s)
| | - Tanya Heim
- University of Pittsburgh School of Medicine
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Berhili S, Guerrouaz MA, Oulhouq Y, Terrab FZ, Moukhlissi M, Idrissi FEAE, Mezouar L. Sino-nasal low-grade chondrosarcoma revealed by isolated bilateral loss of sight: an unprecedented presentation of a rare tumour. Radiol Case Rep 2022; 17:2563-2567. [PMID: 35634018 PMCID: PMC9130089 DOI: 10.1016/j.radcr.2022.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 11/29/2022] Open
Abstract
Chondrosarcomas are malignant cartilage-forming tumors representing less than 0.1% of all head and neck malignancies, and nasal cavity is an exceptional location among them. Clinical presentation could be consisting of either rhinological signs or asymptomatic endonasal mass. None of the previous reports mentioned ophthalmological symptoms at the forefront of the initial presentation. We report a case of sino-nasal low-grade chondrosarcoma in a patient who presented initially with isolated bilateral subtotal blindness, managed by endoscopic resection and adjuvant radiotherapy.
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Martin JR, Auran RL, Duran MD, de Comas AM, Jacofsky DJ. Management of Primary Aggressive Tumors of the Knee. J Knee Surg 2022; 35:585-596. [PMID: 35181876 DOI: 10.1055/s-0042-1743221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Primary bone sarcomas and aggressive benign bone tumors are relatively rare. It is essential to recognize features that are concerning for these aggressive tumors based on a patient's history, physical exam, and radiographs. Physicians and other health care providers should have a high suspicion for these tumors and promptly refer these patients to orthopaedic oncologists. A multidisciplinary, team-based approach is required to obtain an accurate diagnosis and provide comprehensive care. This review discussed the appropriate work-up, biopsy principles, relevant peri-operative medical management, and surgical treatment options for patients with aggressive primary bone tumors around the knee. Primary bone sarcomas (osteosarcoma and chondrosarcoma) and aggressive benign bone tumors (giant cell tumor, chondroblastoma, and chondromyxoid fibroma) that have a predilection to the distal femur and proximal tibia are the focus of this review.
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Affiliation(s)
- John R Martin
- Department of Orthopaedic Surgery, University of Arizona College of Medicine, Phoenix, Arizona
| | - Richard L Auran
- Department of Orthopaedic Surgery, University of Arizona College of Medicine, Phoenix, Arizona
| | - Michael D Duran
- The Center for Orthopedic Research and Eduction (CORE) Institute, Phoenix, Arizona
| | - Amalia M de Comas
- Department of Orthopaedic Surgery, University of Arizona College of Medicine, Phoenix, Arizona.,The Center for Orthopedic Research and Eduction (CORE) Institute, Phoenix, Arizona
| | - David J Jacofsky
- The Center for Orthopedic Research and Eduction (CORE) Institute, Phoenix, Arizona
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Gupta N, Pandey AK, Dimri K, Singhal SK, Rathee N, Naryal S, Sharma P, Upadhyay AK. Chondrosarcoma of the Nasal Septum—A Rare Subsite: Case Report with Review of Literature. Indian J Med Paediatr Oncol 2021. [DOI: 10.1055/s-0041-1736210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
AbstractChondrosarcomas are the second most common primary malignant bone tumors. Head and neck chondrosarcomas constitute less than 10% of these tumors, rarely arising from the nasal septum. These are locally aggressive malignant tumors arising from the cartilaginous framework of the nasal septum. Rarity of the tumor coupled with nonspecific symptoms makes it a diagnostic dilemma. Diagnosis requires endoscopy, radiology, and final histopathology for confirmation. Treatment is mainly surgical, requiring complete surgical excision with clear margins. Radiation has a role in unresectable tumors or for tumors with positive margins after surgery. Survival depends on the grade of tumor that predicts the metastatic potential of the tumor. We present a rare case of chondrosarcoma arising from the nasal septum in a 29-year-old young female presenting with complaints of nasal obstruction. Computed tomography was suggestive of a calcified cartilaginous tumor arising from the nasal septum. Endoscopic excision was done and postoperative histopathology showed grade II chondrosarcoma with clear margins. No adjuvant treatment was given to our patient and 2 years post-excision patient is disease free.To conclude, chondrosarcoma of the nasal septum is a rare tumor, with nonspecific symptoms. Surgery with clear margins remains the treatment of choice. Prognosis depends on the extent of tumor at presentation, resection margins, and grade of tumor.
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Affiliation(s)
- Nidhi Gupta
- Department of Radiation Oncology, Government Medical College and Hospital, Chandigarh, India
| | - Awadhesh Kumar Pandey
- Department of Radiation Oncology, Government Medical College and Hospital, Chandigarh, India
| | - Kislay Dimri
- Department of Radiation Oncology, Government Medical College and Hospital, Chandigarh, India
| | - Surinder K Singhal
- Department of ENT, Government Medical College and Hospital, Chandigarh, India
| | - Neeraj Rathee
- Department of Radiation Oncology, Government Medical College and Hospital, Chandigarh, India
| | - Shalu Naryal
- Department of Radiation Oncology, Government Medical College and Hospital, Chandigarh, India
| | - Pooja Sharma
- Department of Pathology, Government Medical College and Hospital, Chandigarh, India
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Li W, Dong S, Wang H, Wu R, Wu H, Tang ZR, Zhang J, Hu Z, Yin C. Risk analysis of pulmonary metastasis of chondrosarcoma by establishing and validating a new clinical prediction model: a clinical study based on SEER database. BMC Musculoskelet Disord 2021; 22:529. [PMID: 34107945 PMCID: PMC8191035 DOI: 10.1186/s12891-021-04414-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/28/2021] [Indexed: 02/02/2023] Open
Abstract
Background The prognosis of lung metastasis (LM) in patients with chondrosarcoma was poor. The aim of this study was to construct a prognostic nomogram to predict the risk of LM, which was imperative and helpful for clinical diagnosis and treatment. Methods Data of all chondrosarcoma patients diagnosed between 2010 and 2016 was queried from the Surveillance, Epidemiology, and End Results (SEER) database. In this retrospective study, a total of 944 patients were enrolled and randomly splitting into training sets (n = 644) and validation cohorts(n = 280) at a ratio of 7:3. Univariate and multivariable logistic regression analyses were performed to identify the prognostic nomogram. The predictive ability of the nomogram model was assessed by calibration plots and receiver operating characteristics (ROCs) curve, while decision curve analysis (DCA) and clinical impact curve (CIC) were applied to measure predictive accuracy and clinical practice. Moreover, the nomogram was validated by the internal cohort. Results Five independent risk factors including age, sex, marital, tumor size, and lymph node involvement were identified by univariate and multivariable logistic regression. Calibration plots indicated great discrimination power of nomogram, while DCA and CIC presented that the nomogram had great clinical utility. In addition, receiver operating characteristics (ROCs) curve provided a predictive ability in the training sets (AUC = 0.789, 95% confidence interval [CI] 0.789–0.808) and the validation cohorts (AUC = 0.796, 95% confidence interval [CI] 0.744–0.841). Conclusion In our study, the nomogram accurately predicted risk factors of LM in patients with chondrosarcoma, which may guide surgeons and oncologists to optimize individual treatment and make a better clinical decisions. Trial registration JOSR-D-20-02045, 29 Dec 2020.
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Affiliation(s)
- Wenle Li
- Department of Orthopedics, Xianyang Central Hospital, Xianyang, 712000, China.,Clinical Medical Research Center, Xianyang Central Hospital, Xianyang, 712000, China
| | - Shengtao Dong
- Department of Spine Surgery, Second Affiliated Hospital of Dalian Medical University, Dalian, 116000, China
| | - Haosheng Wang
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, 130000, China
| | - Rilige Wu
- Medical Big Data Research Center, Medical Innovation Research Division of Chinese PLA General Hospital, Beijing, 100853, China.,National Engineering Laboratory for Medical Big Data Application Technology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Huitao Wu
- Intelligent Healthcare Team, Baidu Inc., Beijing, 100089, China
| | - Zhi-Ri Tang
- School of Physics and Technology, Wuhan University, Wuhan, 430072, China
| | - Junyan Zhang
- Medical Big Data Research Center, Medical Innovation Research Division of Chinese PLA General Hospital, Beijing, 100853, China.,National Engineering Laboratory for Medical Big Data Application Technology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Zhaohui Hu
- Department of Spine Surgery, Liuzhou People's Hospital, Liuzhou, 545000, China.
| | - Chengliang Yin
- Faculty of Medicine, Macau University of Science and Technology, Macau, 999078, China.
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Wang Z, Chen G, Chen X, Huang X, Liu M, Pan W, Yan X, Lin N, Ye Z. Predictors of the survival of patients with chondrosarcoma of bone and metastatic disease at diagnosis. J Cancer 2019; 10:2457-2463. [PMID: 31258751 PMCID: PMC6584356 DOI: 10.7150/jca.30388] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 04/07/2019] [Indexed: 12/13/2022] Open
Abstract
Purpose: Chondrosarcoma with metastatic disease has a very poor prognosis. However, the prognosis and potential prognostic factors of patients with primary chondrosarcoma of bone and metastasis at presentation have not been documented because of its rarity. Therefore, we examined the prognosis of this special cohort and identify possible prognostic factors. Methods: The Surveillance, Epidemiology, and End Results (SEER) program database was used to identify patients with primary chondrosarcoma of bone and metastatic disease at diagnosis from 2000 to 2013. The prognostic analysis was performed using the Kaplan-Meier method and a Cox proportional hazards regression model. Results: The SEER database contained 264 cases. The overall survival (OS) and cancer-survival specific (CSS) rates of the entire group at 5 years were 28.4% and 31.2%, respectively. The median OS and CSS were 14.0 ± 2.5 and 17.0 ± 2.6 months, respectively. Multivariate analysis revealed that low tumor grade, surgical treatment, tumor size < 10 cm, and first primary tumor were associated with improved OS. Tumor grade, tumor size, and surgery were independent predictors of CSS. Radiation therapy had no effect on either OS or CSS. Conclusion: Among patients with primary chondrosarcoma of bone and metastasis at presentation, low tumor grade, surgical treatment, tumor size < 10 cm, and first primary tumor predict prolonged survival.
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Affiliation(s)
- Zhan Wang
- Department of Orthopaedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang 310000, P.R. China
| | - Genlian Chen
- Department of Orthopaedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang 310000, P.R. China
| | - Xiaowei Chen
- Department of Orthopaedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang 310000, P.R. China
| | - Xin Huang
- Department of Orthopaedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang 310000, P.R. China
| | - Meng Liu
- Department of Orthopaedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang 310000, P.R. China
| | - Weibo Pan
- Department of Orthopaedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang 310000, P.R. China
| | - Xiaobo Yan
- Department of Orthopaedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang 310000, P.R. China
| | - Nong Lin
- Department of Orthopaedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang 310000, P.R. China
| | - Zhaoming Ye
- Department of Orthopaedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang 310000, P.R. China
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Bajpai J, Khanna N, Vora T, Gulia A, Laskar S, Puri A, Sanduptla B, Chinnaswamy G, Nayak P, Juvekar SL, Janu A, Desai S, Ghosh J, Purandare N, Ramadwar M, Rangarajan V, Rekhi B. Analysis of bone and soft-tissue sarcomas registered during the year 2012 at Tata Memorial Hospital, Mumbai, with clinical outcomes. Indian J Cancer 2018; 55:37-44. [PMID: 30147091 DOI: 10.4103/ijc.ijc_481_17] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Introduction Primary bone and soft tissue sarcomas are rare, but diagnostically and therapeutically challenging group of tumors, requiring multidisciplinary management. There are limited documented studies from multidisciplinary teams , in the form of comprehensive analysis of these tumors, from our country. This study is an analysis of cases of osteosarcomas, Ewing sarcomas (ESs), chondrosarcomas (CSs), and soft-tissue sarcomas (STSs), registered at our institution during 2012. Methods Clinical details, including outcomes of cases of bone and STSs, during the year 2012, were retrieved from the medical records of our institution and were further analyzed. Results Ninety-five high-grade, extremity-based, treatment-naïve cases of osteosarcomas were treated with a novel, dose-dense, nonhigh-dose methotrexate-based OGS-12 protocol. Good histopathologic response (necrosis ≥90%) was achieved in 59% nonmetastatic and 56% metastatic patients. At a median follow-up of 48 months, the estimated 5-year event-free survival and overall survival (OS) were 67% and 78%, respectively. In the metastatic cohort at a median follow-up of 51 months, the 5-year estimated progression-free survival was 24% and OS was 26%. Among 87 (73.2%) nonmetastatic and 32 (26.8%) metastatic, analyzable cases of ES, at a median follow-up of 40 months, the disease-free survival (DFS) and OS in the nonmetastatic group were 62% and 83%; in the metastatic group, they were 37.5% and 65.6%, respectively. Among 40 cases of CSs (33 nonmetastatic and 7 metastatic), 21 had limb salvage surgery while 5 had amputation. Microscopically, 90.4% were Grade II CSs. Five-year OS and DFS were 84.6% and 71%, respectively. Among 189 high-grade, extremity-based STSs (89% nonmetastatic), synovial sarcoma was the most common subtype (31%). Eighty-five percent had limb preservation surgery; a majority were offered adjuvant radiation with or without chemotherapy. At a median follow-up of 51 (1-63) months, 3-year local control, DFS, and OS were 81%, 48%, and 64%, respectively. Conclusions The novel OGS 12 and Ewing Family of Tumors 2001 protocols have shown comparable outcomes to international standards in cases of osteosarcoma and ES, respectively, and merit wider applications, especially in low- and middle-income countries (LMICs). Outcomes in STS and CSs were also comparable and underscore the importance of a multidisciplinary approach for the management of sarcomas in LMICS.
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Affiliation(s)
- Jyoti Bajpai
- Department of Medical Oncology, Clinical Research Secretariat, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Nehal Khanna
- Department of Radiation Oncology, Clinical Research Secretariat, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Tushar Vora
- Department of Medical Oncology, Clinical Research Secretariat, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Ashish Gulia
- Department of Surgical Oncology, Clinical Research Secretariat, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Siddhartha Laskar
- Department of Radiation Oncology, Clinical Research Secretariat, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Ajay Puri
- Department of Surgical Oncology, Clinical Research Secretariat, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Bhanupriya Sanduptla
- Trial Coordinator, Clinical Research Secretariat, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Girish Chinnaswamy
- Department of Medical Oncology, Clinical Research Secretariat, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Prakash Nayak
- Department of Surgical Oncology, Clinical Research Secretariat, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Shashikant L Juvekar
- Department of Radio Diagnosis, Bone and Soft Tissues, Disease Management Group (DMG), Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Amit Janu
- Department of Radio Diagnosis, Bone and Soft Tissues, Disease Management Group (DMG), Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Subhash Desai
- Department of Radio Diagnosis, Bone and Soft Tissues, Disease Management Group (DMG), Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Jaya Ghosh
- Department of Medical Oncology, Clinical Research Secretariat, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Nilendu Purandare
- Department of Nuclear Medicine and Molecular Imaging, Bone and Soft Tissues, Disease Management Group (DMG), Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Mukta Ramadwar
- Department of Surgical Pathology, Bone and Soft Tissues, Disease Management Group (DMG), Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Venkatesh Rangarajan
- Department of Nuclear Medicine and Molecular Imaging, Bone and Soft Tissues, Disease Management Group (DMG), Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Bharat Rekhi
- Department of Surgical Pathology, Bone and Soft Tissues, Disease Management Group (DMG), Tata Memorial Hospital, Mumbai, Maharashtra, India
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10
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Belgioia L, Vaccara EM, Bacigalupo A, Corvò R. Management of Nasal Septum Chondrosarcoma Occurring in Elderly: A Case Report. Cureus 2017; 9:e1497. [PMID: 28948117 PMCID: PMC5606711 DOI: 10.7759/cureus.1497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Chondrosarcomas (CS) are tumors affecting mainly pelvis, long bones and ribs in middle aged people; involvement of head and neck is rare and nasal septum location is exceptional. We report the follow-up of an 85-year-old patient suffering from head and neck CS. Magnetic resonance imaging (MRI) showed a mass originating from nasal septum. The patient underwent to debulking surgery and adjuvant hypofractionated radiotherapy with excellent tolerability and no evidence of recurrence after 16 months. Hypofractionated radiotherapy delivered with advanced technique (helical tomotherapy) allowed to deliver high doses radiation in elderly patients with limited toxicity.
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Affiliation(s)
- Liliana Belgioia
- Radiation Oncology, University of Genoa Ospedale Policlinico San Martino
| | - Elena M Vaccara
- Medical Physics, University of Genoa Ospedale Policlinico San Martino
| | | | - Renzo Corvò
- Radiation Oncology, University of Genoa Ospedale Policlinico San Martino
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11
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Salunke AA. Letter to the Editor: Correlation between survival and tumour characteristics in patients with chondrosarcoma. J Orthop Surg (Hong Kong) 2016; 24:138. [PMID: 27122534 DOI: 10.1177/230949901602400138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- A A Salunke
- Gujarat Cancer Research Institute, Ahemdabad, Gujarat, India
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