Chondrosarcoma surgery: Difference between revisions

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Revision as of 21:01, 23 January 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]

Overview

Surgery is the mainstay of treatment for chondrosarcoma. Adjunctive chemotherapy and radiation may be required.

Surgery

Surgery is the mainstay of treatment for chondrosarcoma.

intra-lesional curettage indications Grade 1 lesions in the extremities (minimal rate of metastasis) treatment of grade 1 lesions located in the pelvis or axial skeleton is controversial (higher rate of local recurrence and metastasis) most authors recommend wide excision of all chondrosarcomas (even grade 1) if located in the pelvis wide surgical excision indications grade 2 or 3 lesions grade 1 lesions in pelvis wide surgical excision combined with multi-agent chemotherapy indications mesenchymal chondrosarcoma the role of chemotherapy in de-differentiated chondrosarcoma is very controversial

Recurrence Rate

Grade 1 chondrosarcoma

It is rare after wide resection with negative margins.
5-15% is the recurrence rate after curettage with adjuvant treatment.

Grade 2 chondrosarcoma

The recurrence rate varies depending on resection margins.

Grade 3 chondrosarcoma

The local recurrence rate is 25% and >30% chances of metastasis.

References

Template:WikiDoc Sources

@@ Line 5: / Line 5: @@
 ==Overview==
-Surgical intervention is not recommended for the management of [disease name].
+Surgery is the mainstay of treatment for chondrosarcoma. Adjunctive [[chemotherapy]] and [[radiation]] may be required.
-OR
-Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]
+==Surgery==
+*Surgery is the mainstay of treatment for chondrosarcoma.
-OR
-The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].
-OR
-The feasibility of surgery depends on the stage of [malignancy] at diagnosis.
-OR
-Surgery is the mainstay of treatment for [disease or malignancy].
-==Indications==
-*Surgical intervention is not recommended for the management of [disease name].
+intra-lesional curettage
-OR
+indications
-*Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either:
+Grade 1 lesions in the extremities (minimal rate of metastasis)
-**[Indication 1]
+treatment of grade 1 lesions located in the pelvis or axial skeleton is controversial (higher rate of local recurrence and metastasis)
-**[Indication 2]
+most authors recommend wide excision of all chondrosarcomas (even grade 1) if located in the pelvis
-**[Indication 3]
+wide surgical excision
-*The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either:
+indications
-**[Indication 1]
+grade 2 or 3 lesions
-**[Indication 2]
+grade 1 lesions in pelvis
-**[Indication 3]
+wide surgical excision combined with multi-agent chemotherapy
+indications
+mesenchymal chondrosarcoma
+the role of chemotherapy in de-differentiated chondrosarcoma is very controversial
-==Surgery==
+===Recurrence Rate===
+'''Grade 1 chondrosarcoma'''
+*It is rare after wide resection with negative margins.
+*5-15% is the recurrence rate after curettage with adjuvant treatment.
-*The feasibility of surgery depends on the stage of [malignancy] at diagnosis.
+'''Grade 2 chondrosarcoma'''
-OR
+*The recurrence rate varies depending on resection margins.
-*Surgery is the mainstay of treatment for [disease or malignancy].
-==Contraindications==
+'''Grade 3 chondrosarcoma'''
+*The local recurrence rate is 25% and >30% chances of metastasis.
 ==References==
 {{Reflist|2}}
-==Overview==
-The predominant therapy for chondrosarcoma is surgical resection. Adjunctive [[chemotherapy]] and [[radiation]] may be required.
-==Surgery==
-Because chondrosarcoma affects different parts of the body, the type of treatment depends on the size, location, and grade of the tumor. Musculoskeletal tumor Specialists or Orthopedic Oncologists are the most qualified to treat chondrosarcoma, unless it is located in the skull, spine, or chest cavity, in which case, a Neurosurgeon or Thoracic surgeon experienced with sarcomas would be needed.
-*Surgery is the main form of treatment for chondrosarcoma.
-*Treatment depends on the location of the disease and the aggressiveness of the tumors. Often, a limb-sparing operation can be performed<ref>{{Cite web | title =Limb sparing surgery| url =http://www.seattlecca.org/patientsandfamilies/adultCare/clinicalProgs/sarcoma/BoneCancerTreatmentOptions/LimbSparingSurgery.htm}}</ref>, however in some cases amputation is unavoidable.
-*[[Amputation]] of the [[arm]], [[leg]], [[jaw]], or half of the [[pelvis]] (called a [[hemipelvectomy]]) may be necessary in some cases.
-*There are two kinds of hemipelvectomy (internal and external):
-**External hemipelvectomy is removal of that half of the pelvis with the [[amputation]] of the leg. It is also called the hindquarter amputation.
-**Internal hemipelvectomy is removal of that half of the pelvis, but the leg is left intact.
-*Even more rare are chondrosarcoma located in the skull base, spine, rib cage, or larynx. Complete surgical ablation is the treatment, but sometimes this is difficult. [[Proton therapy]] Radiation can be useful in these rare locations to make surgery more effective.
-*Follow up scans are extremely important for chondrosarcoma to make sure there has been no recurrence or [[metastasis]], which usually occurs in the lungs. Unlike other cancers, chondrosarcoma can return many years later.
-==References==
-{{reflist|2}}
-[[Category:Disease]]
-[[Category:Orthopedics]]
-[[Category:Types of cancer]]
-[[Category:Skeletal disorders]]
 {{WikiDoc Help Menu}}
 {{WikiDoc Sources}}
- [[Category:Up-To-Date]]
+[[Category:Up-To-Date]]
 [[Category:Oncology]]
 [[Category:Medicine]]
 [[Category:Orthopedics]]