Kondrosarkomlu hastaların prognostik faktörleri ve tedavisi: kurumsal deneyim

Yıl 2025, Cilt: 7 Sayı: 5, 657 - 664, 15.09.2025

Tuğba Önder , Ülkü Yalçıntaş , Öztürk Ateş , Necati Alkış

https://doi.org/10.38053/acmj.1756949

Öz

Amaç ve Hedefler: Kondrosarkom (KS) hastalarının prognostik faktörleri ve tedavi yöntemlerine ilişkin veriler sınırlıdır. KS hastalarımızla ilgili deneyimlerimizi sunmayı amaçladık.

Gereç ve Yöntemler: 2010-2023 yılları arasında Kanser Enstitümüzde KS tanısı almış 69 hastanın tıbbi kayıtları retrospektif olarak incelendi.

Bulgular: Ortanca yaş 47 idi; 93 aylık takipte hafif bir erkek predominansı (%52) gözlendi. Grade 1 (%34) ve 2 (%34) KS'ler en sık görülenlerdi ve alt ekstremiteler (%40) ve pelvis (%26) için bir eğilim vardı. 63 hasta lokalize hastalık, 6 hasta ise metastazla presente oldu. Takip sırasında 13 hastada daha metastaz görüldü. Akciğer en sık metastaz bölgesiydi.

Lokalize hastalığı olan 63 hastanın tamamı ameliyat edildi; 7 hasta adjuvan kemoterapi (CT) aldı. 26 hastada nüks görüldü; 9 hasta sistemik kanser tedavisi aldı. Evre 4 hastalık tanısı alan 6 hastanın 5 ine palyatif cerrahi uygulandı, 5 ine CT uygulandı. En sık kullanılan tedavi rejimleri doksorubisin bazlı CT, pazopanib, sirolimus ve selekoksib idi.

Takip sırasında metastaz gelişen 13 hastanın 12'si hayatını kaybetti; tanıdan metastaza kadar geçen medyan süre 17,0 (95% CI: 10,8-23,1) ve metastaz sonrası medyan sağ kalım 21,0 (95% CI: 12,7-29,2) aydı. Başlangıçta metastatik olan altı hastanın tamamı hayatını kaybetmişti; medyan progresyonsuz sağ kalım 7 (95% CI: 2,1-11,8) ve genel sağ kalım (OS) 12 (95% CI: 0,00-33,60) aydı.

OS, tüm grup için sırasıyla 5, 10 ve 15. yıllarda %75, %63 ve %57 idi. Tek değişkenli analizde kadın cinsiyet, düşük-orta grade, evre 1-2 tümörler uzamış OS ile ilişkiliydi. Çok değişkenli analizde, tanı anındaki evre OS için tek anlamlı faktördü (p=0,002).

Sonuç: Yapılan analizler, tümörün erken evrede olmasının iyileşmiş genel sağkalım için önemli bir faktör olduğunu ortaya koydu.

Anahtar Kelimeler

Kemoterapi , cerrahi , radyoterapi , akciğer metastazı , kondrosarkom

Prognostic factors and treatment of patients with chondrosarcoma: a single institutional experience

Öz

Aims: Prognostic factors and treatment modalities in chondrosarcoma (CS) remain poorly defined. This study aimed to present our institutional experience with CS patients.
Methods: We retrospectively reviewed the medical records of 69 CS patients treated at our Cancer Institute between 2010 and 2023.
Results: Median age at diagnosis was 47 years, with a slight male predominance (52%) and a median follow-up of 93 months. Grade 1 (34%) and grade 2 (34%) tumors were most common, predominantly affecting the lower extremities (40%) and pelvis (26%). At presentation, 63 patients had localized disease and 6 had metastases; metastases later developed in 13 additional patients, most frequently in the lungs. All 63 patients with localized disease underwent surgery, and 7 received adjuvant chemotherapy (CT). Recurrence developed in 26 patients, of whom 9 were treated with systemic therapy. Among 6 patients with stage IV disease, 5 underwent palliative surgery and received CT. The most commonly used regimens included doxorubicin based CT, pazopanib, sirolimus, and celecoxib. Among patients who developed metastasis during follow-up, 12/13 died. The median time from diagnosis to metastasis was 17.0 months (95% CI: 10.8–23.1), and median survival thereafter was 21.0 months (95% CI: 12.7–29.2). All six patients metastatic at presentation died, with a median progression-free survival of 7.0 months (95% CI: 2.1–11.8) and OS of 12.0 months (95% CI: 0.0–33.6). OS was 75%, 63%, and 57% at 5, 10, and 15 years, respectively. Female sex, low–intermediate grade, and stage I–II disease correlated with better OS in univariate analysis, but only stage at diagnosis remained significant in multivariate analysis (p=0.002).
Conclusion: Our findings highlight that early tumor stage is the only independent predictor of overall survival, underscoring the critical importance of early diagnosis and timely intervention in CS.

Anahtar Kelimeler

Chemotherapy , surgery , radiotherapy , lung metastasis , chondrosarcoma

Etik Beyan

The studies involving human participants were reviewed and approved by The Ethics Committee of our Hospital. According to national legislation and institutional standards, participation in this study did not require written informed consent.

Destekleyen Kurum

Not.

Kaynakça

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