Comparisons of clinical characteristics, treatments, and outcomes among different pathological subtypes of chondrosarcoma in the spine.

Autor: Sun J; Department of Orthopedic Oncology, Shanghai Changzheng Hospital, Naval Medical University, #415 Fengyang Road, Shanghai, 200003, China.; Wuxi School of Medicine, Jiangnan University, 1800 Lihu Avenue, Wuxi, 214122, Jiangsu, China., Wu Z; Department of Orthopedic Oncology, Shanghai Changzheng Hospital, Naval Medical University, #415 Fengyang Road, Shanghai, 200003, China., Jiao J; Department of Orthopedic Oncology, Shanghai Changzheng Hospital, Naval Medical University, #415 Fengyang Road, Shanghai, 200003, China., Wei H; Department of Orthopedic Oncology, Shanghai Changzheng Hospital, Naval Medical University, #415 Fengyang Road, Shanghai, 200003, China., Yang X; Department of Orthopedic Oncology, Shanghai Changzheng Hospital, Naval Medical University, #415 Fengyang Road, Shanghai, 200003, China., Liu T; Department of Orthopedic Oncology, Shanghai Changzheng Hospital, Naval Medical University, #415 Fengyang Road, Shanghai, 200003, China., Zhao J; Department of Orthopedic Oncology, Shanghai Changzheng Hospital, Naval Medical University, #415 Fengyang Road, Shanghai, 200003, China., Yang C; Department of Orthopedic Oncology, Shanghai Changzheng Hospital, Naval Medical University, #415 Fengyang Road, Shanghai, 200003, China., Xu W; Department of Orthopedic Oncology, Shanghai Changzheng Hospital, Naval Medical University, #415 Fengyang Road, Shanghai, 200003, China., Zhou Z; Department of Orthopedic Oncology, Shanghai Changzheng Hospital, Naval Medical University, #415 Fengyang Road, Shanghai, 200003, China. article_zzh@126.com., Wang T; Department of Orthopedic Oncology, Shanghai Changzheng Hospital, Naval Medical University, #415 Fengyang Road, Shanghai, 200003, China. wangt_boneleven@163.com., Xiao J; Department of Orthopedic Oncology, Shanghai Changzheng Hospital, Naval Medical University, #415 Fengyang Road, Shanghai, 200003, China. jianruxiao83@163.com.
Jazyk: angličtina
Zdroj: Journal of neuro-oncology [J Neurooncol] 2024 Dec; Vol. 170 (3), pp. 641-653. Date of Electronic Publication: 2024 Sep 14.
DOI: 10.1007/s11060-024-04823-y
Abstrakt: Introduction: Spinal chondrosarcoma exhibits higher invasiveness and a worse prognosis compared to chondrosarcoma in the extremities. The prognosis and therapeutic plan vary greatly among different pathological subtypes of chondrosarcoma. This study aimed to analyze the differences in clinical characteristics, molecular features, therapeutic effects, and prognostic factors among the subtypes of chondrosarcoma in the spine.
Methods: A retrospective review was conducted on 205 patients with spinal chondrosarcoma. The clinical features and immunohistochemical (IHC) markers were compared among the pathological subtypes of chondrosarcoma grade 1, grade 2, grade 3, mesenchymal chondrosarcoma (MCS), dedifferentiated chondrosarcoma (DCS), and clear cell chondrosarcoma (CCCS). Chondrosarcoma grade 1/2/3 are collectively referred to as conventional chondrosarcoma (CCS) for multivariate survival analysis. Univariate and multivariate analyses were performed to investigate independent prognostic factors for overall survival (OS) and recurrence-free survival (RFS) in patients with spinal chondrosarcoma. Furthermore, independent prognostic factors for OS and RFS were identified in CCS and MCS.
Results: MCS patients were younger than the other subtypes. Patients with chondrosarcoma grade 1/2 had better OS than those with chondrosarcoma grade 3, MCS and DCS, while only chondrosarcoma grade 1 patients showed better RFS than chondrosarcoma grade 2/3, MCS and DCS patients. Ki-67 index was higher in chondrosarcoma grade 3, MCS and DCS than chondrosarcoma grade 1/2. The comparison of IHC markers further highlighted the overexpression of P53/MDM2 in MCS and DCS. Gross total resection, including en-bloc and piecemeal resection, significantly improved OS and RFS for CCS patients, while only en-bloc resection significantly improved the prognosis of MCS patients. Chemotherapy appeared to be important for the OS of MCS patients.
Conclusion: P53/MDM2 pathway was upregulated in MCS and DCS compared to chondrosarcoma grade 1/2. Radical tumor resection is crucial for the treatment of spinal chondrosarcoma, while MCS patients require further comprehensive treatments perioperatively.
Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethical approval: This research project was examined and approved by the medical ethics committee of Shanghai Changzheng Hospital (2018SL004), and written informed consent was obtained from all patients or their legal guardians. Consent for publication: Informed consent was obtained from all subjects involved in the study.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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