Prognostic factors and treatment of patients with chondrosarcoma: a single institutional experience

Aims: Prognostic factors and treatment modalities in chondrosarcoma (CS) remain poorly defined. This study aimed to present our institutional experience with CS patients. Methods: We retrospectively reviewed the medical records of 69 CS patients treated at our Cancer Institute between 2010 and 2023. Results: Median age at diagnosis was 47 years, with a slight male predominance (52%) and a median follow-up of 93 months. Grade 1 (34%) and grade 2 (34%) tumors were most common, predominantly affecting the lower extremities (40%) and pelvis (26%). At presentation, 63 patients had localized disease and 6 had metastases; metastases later developed in 13 additional patients, most frequently in the lungs. All 63 patients with localized disease underwent surgery, and 7 received adjuvant chemotherapy (CT). Recurrence developed in 26 patients, of whom 9 were treated with systemic therapy. Among 6 patients with stage IV disease, 5 underwent palliative surgery and received CT. The most commonly used regimens included doxorubicin based CT, pazopanib, sirolimus, and celecoxib. Among patients who developed metastasis during follow-up, 12/13 died. The median time from diagnosis to metastasis was 17.0 months (95% CI: 10.8–23.1), and median survival thereafter was 21.0 months (95% CI: 12.7–29.2). All six patients metastatic at presentation died, with a median progression-free survival of 7.0 months (95% CI: 2.1–11.8) and OS of 12.0 months (95% CI: 0.0–33.6). OS was 75%, 63%, and 57% at 5, 10, and 15 years, respectively. Female sex, low–intermediate grade, and stage I–II disease correlated with better OS in univariate analysis, but only stage at diagnosis remained significant in multivariate analysis (p=0.002). Conclusion: Our findings highlight that early tumor stage is the only independent predictor of overall survival, underscoring the critical importance of early diagnosis and timely intervention in CS.