A Review of the Behaviour of Chondrosarcoma of Bone

Sixty-two cases of chondrosarcoma of bone were reviewed and histologically graded as low, medium or high-grade tumours. After excluding patients dead from unrelated causes or lost to follow-up, forty cases were available for ten-year follow-up and fifty-eight for five-year follow-up. The rates of survival, recurrence and metastasis were analysed according to the histological grading. Recurrence was further analysed according to the adequacy of treatment. The results were compared with those previously reported in the literature. There was a ten-year survival rate of 58 per cent. Recurrence developed in 58 per cent and was uncontrollable in 29 per cent. The recurrence rate was 87 per cent with inadequate treatment and 15 per cent with adequate treatment. Recurrences outside the limb bones usually proved uncontrollable; recurrences in the limb bones were amenable to further, and if necessary repeated, operations. High-grade chondrosarcoma had a metastatic risk of 75 per cent and eventual mortality of 88 per cent. Medium-grade chondrosarcoma had a metastatic risk of 14 per cent and a mortality of 60 per cent. Low-grade chondrosarcoma had a metastatic risk of 5 per cent and a mortality of 29 per cent. Previous reviews of chondrosarcoma of bone, in particular the large series of Dahlin and Henderson (1956) and Henderson and Dahlin (1963), have firmly established the role of uncontrolled local growth in the fatal outcome of this tumour. They have also shown its usually lengthy progression and emphasised the impor-tance of adequate primary surgical treatment in its management. The adverse effects on the prognosis of the higher grades of chondrosarcoma have also been referred to in a number of studies (O’Neal and Ackerman 1952; Dahlin and Henderson 1956; Lind