The Journal of the Korean bone and joint tumor society (대한골관절종양학회지)

The Korean Musculoskeletal Tumor Society (대한근골격종양학회)
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Oncologic Outcome of Chondrosarcomas

연골육종의 종양학적 결과

  • Kim, Chol Jin (Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Chung, Jun Young (Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Chung, Yang Guk (Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Rhee, Seung Koo (Department of Orthopedic Surgery, Yoido St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kang, Yong Koo (Department of Orthopedic Surgery, St.Vincent Hospital, College of Medicine, The Catholic University of Korea) ;
  • Bahk, Won Jong (Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Shim, Jung In (Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • 김철진 (가톨릭대학교 의과대학 서울성모병원 정형외과학교실) ;
  • 정준영 (가톨릭대학교 의과대학 서울성모병원 정형외과학교실) ;
  • 정양국 (가톨릭대학교 의과대학 서울성모병원 정형외과학교실) ;
  • 이승구 (가톨릭대학교 의과대학 여의도성모병원 정형외과학교실) ;
  • 강용구 (가톨릭대학교 의과대학 성빈센트병원 정형외과학교실) ;
  • 박원종 (가톨릭대학교 의과대학 의정부성모병원 정형외과학교실) ;
  • 심정인 (가톨릭대학교 의과대학 서울성모병원 정형외과학교실)
  • Received : 2013.03.21
  • Accepted : 2013.05.27
  • Published : 2013.06.30
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Abstract

Purpose: We evaluated oncologic outcomes of chondrosarcomas and analyzed the disease-free survival rate of chondrosarcomas according to the various factors. Materials and Methods: We performed a retrospective study for the disease-free survival rate of 48 chondrosarcomas, 44 of which underwent surgical treatment and followed up more than 18 months since 1993, and in the remaining 4 cases, the patients died before 18 months after surgery. The vsariables were location, tumor volume, histologic grade, stage, age at presentation and treatment performed. The mean follow up period was 43.8 months (1-196 months). Results: The overall disease-free survival rate was 77.1% at mean 43.8 month follow up. The 5 year- and 10 year disease-free survival rates were 64% and 58% respectively. The histologic grade, stage, age at presentation revealed statistical significance on disease-free survival. All 9 patients treated with extended curettage for grade 1 central chondrosarcomas revealed disease-free survival with excellent functional outcome. Conclusion: The disease-free survival rate of chondrosarcomas mainly depended on histologic grade, stage and age at presentation. Local recurrence and distant metastasis also revealed statistically significant differences of disease-free survival rate. Comparing to wide resection, extended curettage for low-grade central chondrosarcomas in extremities were efficient methods with similar survival rate and less functional losses and complications.

목적: 연골육종의 종양학적 결과와 무병생존율에 영향을 주는 요인들에 대하여 분석하고자 하였다. 대상 및 방법: 1993년부터 연골육종을 진단 받고 생검술 또는 수술적 치료를 시행 받은 환자 중 설정한 최소 추시기간인 18개월 이전에 사망한 4명을 포함하여 총 48명을 대상으로 하였다. 종양학적 결과를 평가하고 조직학적 등급, 병기, 위치, 용적, 내원시 연령, 수술 절제연, 수술적 치료 방법을 변수로 하여 무병생존율에 미치는 영향에 대하여 후향적 연구를 시행하였다. 추시 기간은 평균 43.8개월(1-196개월)이었다. 결과: 평균 43.8개월 추시상 무병생존율은 77.1%였으며 질병으로 인한 사망 7예(14.6%), 유병 생존 4예(8.3%)였다. 5년 및 10년 무병생존율은 각각 64%와 58%였다. 조직학적 악성도와 외과적 병기, 내원시 연령이 유의한 차이를 나타냈으며, 사지골의 저 악성도 연골육종에서는 광범위 소파술을 시행한 9예 모두에서 무병생존과 우수한 기능적 결과를 보였다. 결론: 연골육종의 무병생존율은 조직학적 악성도와 외과적 병기 및 내원 시의 연령과 관련이 있는 것으로 나타났다. 국소 재발과 원격 전이의 유무 또한 무병생존율과 유의한 상관성을 보였다. 사지골의 저악성도 연골육종에서는 광범위 소파술이 광범위 절제술에 비해 생존율에 영향을 미치지 않으면서 기능소실 및 합병증을 피할 수 있는 효과적인 치료법으로 생각된다.

Keywords

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