Journal
EUROPEAN JOURNAL OF CANCER
Volume 151, Issue -, Pages 150-158Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.ejca.2021.04.017
Keywords
Dedifferentiated chondrosarcoma; Bone sarcoma; Sarcoma; EURO-BOSS; Chemotherapy; Systemic treatment; Complete surgical remission; Survival
Categories
Funding
- Italian Sarcoma Group Research Funds
- Associazione 'Il Pensatore' Matteo Amitrano
- Istituto Ortopedico Rizzoli Research Funds
- IRCCS Istituto Ortopedico Rizzoli Research Fund
- Associazione Mario Campanacci
- Deutsche Krebshilfe [50-2723-Bi2]
- Swedish Cancer Society
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Adding intensive chemotherapy to surgery for the treatment of patients with dedifferentiated chondrosarcoma (DDCS) is feasible and results in favorable survival outcomes compared to previous reports. Despite the limitations of non-controlled trial data, it can be concluded that chemotherapy may be considered in the management of patients over 40 years old.
Introduction: The role of chemotherapy for patients with dedifferentiated chondrosarcoma (DDCS) is still under discussion. Here, we present the outcome in patients with DDCS treated with intensive chemotherapy from the EUROpean Bone Over 40 Sarcoma Study. Materials and methods: The chemotherapy regimen included doxorubicin, ifosfamide and cisplatin. Postoperative methotrexate was added in case of poor histological response. Toxicity was graded based on the National Cancer Institute expanded common toxicity criteria, version 2.0, and survival was analysed using Kaplan-Meier curves, log-rank tests and univariate Cox regression models. Results: Fifty-seven patients with DDCS (localised, 34 [60%]; metastatic, 23 [40%]) aged 42-65 years were included. Surgical complete remission (SCR) was achieved in 36 (63%) patients. The median overall survival (OS) was 24 months (95% confidence interval, 22-25), and the 5-year OS was 39%. Patients with extremity localisation had a 5-year OS of 49% compared with 29% in patients with a central tumour (P = 0.08). Patients with localised disease had a 5-year OS of 46%, whereas patients with metastatic disease had a 5-year OS of 29% (P = 0.12). Patients in SCR had a 5-year OS of 49%, whereas patients not in SCR had a 5-year OS of 23% (P = 0.004). Chemotherapy toxicity was considerable but manageable. There was no treatment-related death, and 39 (70%) patients received >= 6 cycles of the planned nine chemotherapy cycles. Conclusions: Adding intensive chemotherapy to surgery for treatment of DDCS is feasible and shows favourable survival data compared with previous reports. With the limitations of data from a non-controlled trial, we conclude that chemotherapy could be considered in the management of patients aged >40 years. (C) 2021 The Author(s). Published by Elsevier Ltd.
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