Abstract
Purpose: Surgery is the mainstay treatment for chondro-sarcoma. About 35–40% of these tumours are located in the pelvis. Treatment requires significant sacrifices to ensure acceptable survival.
Material and methods: This retrospective analysis of ten patients treated between 1993 and 2001 for pelvic chon-drosaromas was undertaken to examine survival and functional sequelae as a function of treatment and tumour grade. All patients had primary chondrosarcoma. The population included seven men and three women, mean age 50.9 years (range 28–77). Mean survival was 39.7 months.
A biopsy was obtained in all cases (seven under scan guidance). Six patients required complementary surgical biopsy. According to the O’Neel and Ackermann classification, the tumours were grade I in five patients, grade II in two, grade III in three. Tumour classification according to the Enneking topography was: zone I one patient, zone I and II one patient, zone I+II+III one patient, zone II three patients, zone II+III three patients, and zone III one patient. Careful search for extension failed to identify metastasis preoperatively in any patient. For six patients, tumour resection was performed without reconstruction. Resection was associated with a Pugent reconstruction in three patients. All patients were reviewed with an AP view of the pelvis and a chest x-ray.
Results: In sano resection was achieved in eight out of nine patients. For the ninth patient, resection was marginal according to the pathology report. Postoperative survival revealed the presence of metastasis in three patients. One patient developed recurrent tumour. At last follow-up, two patients had died and one had multiple metastases. Seven are currently disease free. Early postoperative complications occurred in 80% of the patients.
Discussion: Currently, surgery remains the treatment of choice for pelvic chondrosarcoma, despite the major perioperative morbidity. Reconstruction, if attempted must always respect the rules of carcinological resection. Reconstruction does not appear to be mandatory since the rate of secondary and late complications remains particularly high in the case of extensive reconstruction. Histological grade, tumour size and quality of surgical resection are the predominant prognostic factors.
The abstracts were prepared by Docteur Jean Barthas. Correspondence should be addressed to him at Secrétariat de la Société S.O.F.C.O.T., 56 rue Boissonade, 75014 Paris.
