Factors That Influence Survival Of Chondrosarcoma Of The Upper Extremities
Gabriela Cinotto1, Maria Huayllani2, Daniel Bczar1, Aaron Spaulding1, Sanjay Bagaria1, Benjamin Wilker1, Antonio Jorge Forte2.
1Mayo Clinic Florida, jacksonville, FL, USA, 2Mayo Clinic Florida, Jacksonville, FL, USA.
PURPOSE: Factors that contribute to increase the survival of the patients with chondrosarcoma helps in the proper management of patients. The 3-year survival rate for chondrosarcomas in general was 74.2%, but factors that may influence in this rate for chondrosarcomas in the upper extremities are still not-well known. This study identified the factors that influence survival of chondrosarcomas of the upper extremities.
METHODS: We analyzed the demographics and tumor characteristics of patients diagnosed with chondrosarcoma of the upper extremities from 2004 to 2010 with a follow-up of 5 years by querying the National Cancer Database (NCDB). Overall survival (OS) at 5 years was compared using Kaplan-Meier method and Cox regression hazard model.
RESULTS: A total of 616 patients with chondrosarcomas of the upper extremities met the inclusion criteria. From these patients, we found a 5-year OS of 89%, 71%, 50% and 19% for AJCC 7th stages I, II, III and IV ( P <.001). Regarding the type of surgery, the 5-year OS for patients that did not have any surgery was 60%, whereas better survival was found in patients who underwent local excisional surgery with limb salvage (89%) compared to patients that had amputation of the limb (76%, P<.001). After adjusting the factors, we did not find an impact in the survival for local excisional surgery with limb salvage compared to the amputation of the limb. On the other hand, older age (HR, 1.07; CI, 1.03-1.09; P<.001) and stage III (HR, 11.88; CI, 1.74-81.20; P=.01) were negative prognostic factors for the survival.
CONCLUSION: Our study identified that age and stage were factors associated with poor survival outcomes in chondrosarcomas of the upper extremities. There are still patients undergoing amputation of the limb, even when no difference in survival was found between these two procedures.
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