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Outcome in dedifferentiated chondrosarcoma for patients treated with multimodal therapy : Results from the EUROpean Bone Over 40 Sarcoma Study

Hompland, Ivar ; Ferrari, Stefano ; Bielack, Stefan ; Palmerini, Emanuela ; Hall, Kirsten S. ; Picci, Pierro ; Hecker-Nolting, Stefanie ; Donati, Davide M. ; Blattmann, Claudia and Bjerkehagen, Bodil , et al. (2021) In European Journal of Cancer 151. p.150-158
Abstract

Introduction: The role of chemotherapy for patients with dedifferentiated chondrosarcoma (DDCS) is still under discussion. Here, we present the outcome in patients with DDCS treated with intensive chemotherapy from the EUROpean Bone Over 40 Sarcoma Study. Materials and methods: The chemotherapy regimen included doxorubicin, ifosfamide and cisplatin. Postoperative methotrexate was added in case of poor histological response. Toxicity was graded based on the National Cancer Institute expanded common toxicity criteria, version 2.0, and survival was analysed using Kaplan-Meier curves, log-rank tests and univariate Cox regression models. Results: Fifty-seven patients with DDCS (localised, 34 [60%]; metastatic, 23 [40%]) aged 42–65 years were... (More)

Introduction: The role of chemotherapy for patients with dedifferentiated chondrosarcoma (DDCS) is still under discussion. Here, we present the outcome in patients with DDCS treated with intensive chemotherapy from the EUROpean Bone Over 40 Sarcoma Study. Materials and methods: The chemotherapy regimen included doxorubicin, ifosfamide and cisplatin. Postoperative methotrexate was added in case of poor histological response. Toxicity was graded based on the National Cancer Institute expanded common toxicity criteria, version 2.0, and survival was analysed using Kaplan-Meier curves, log-rank tests and univariate Cox regression models. Results: Fifty-seven patients with DDCS (localised, 34 [60%]; metastatic, 23 [40%]) aged 42–65 years were included. Surgical complete remission (SCR) was achieved in 36 (63%) patients. The median overall survival (OS) was 24 months (95% confidence interval, 22–25), and the 5-year OS was 39%. Patients with extremity localisation had a 5-year OS of 49% compared with 29% in patients with a central tumour (P = 0.08). Patients with localised disease had a 5-year OS of 46%, whereas patients with metastatic disease had a 5-year OS of 29% (P = 0.12). Patients in SCR had a 5-year OS of 49%, whereas patients not in SCR had a 5-year OS of 23% (P = 0.004). Chemotherapy toxicity was considerable but manageable. There was no treatment-related death, and 39 (70%) patients received ≥6 cycles of the planned nine chemotherapy cycles. Conclusions: Adding intensive chemotherapy to surgery for treatment of DDCS is feasible and shows favourable survival data compared with previous reports. With the limitations of data from a non-controlled trial, we conclude that chemotherapy could be considered in the management of patients aged >40 years.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bone sarcoma, Chemotherapy, Complete surgical remission, Dedifferentiated chondrosarcoma, EURO-B.O.S.S., Sarcoma, Survival, Systemic treatment
in
European Journal of Cancer
volume
151
pages
9 pages
publisher
Elsevier
external identifiers
  • scopus:85105724557
  • pmid:33990016
ISSN
0959-8049
DOI
10.1016/j.ejca.2021.04.017
language
English
LU publication?
yes
id
6cbcc0b5-dd85-4d11-84a0-c0a49105d7aa
date added to LUP
2021-06-01 09:25:53
date last changed
2024-06-15 11:50:33
@article{6cbcc0b5-dd85-4d11-84a0-c0a49105d7aa,
  abstract     = {{<p>Introduction: The role of chemotherapy for patients with dedifferentiated chondrosarcoma (DDCS) is still under discussion. Here, we present the outcome in patients with DDCS treated with intensive chemotherapy from the EUROpean Bone Over 40 Sarcoma Study. Materials and methods: The chemotherapy regimen included doxorubicin, ifosfamide and cisplatin. Postoperative methotrexate was added in case of poor histological response. Toxicity was graded based on the National Cancer Institute expanded common toxicity criteria, version 2.0, and survival was analysed using Kaplan-Meier curves, log-rank tests and univariate Cox regression models. Results: Fifty-seven patients with DDCS (localised, 34 [60%]; metastatic, 23 [40%]) aged 42–65 years were included. Surgical complete remission (SCR) was achieved in 36 (63%) patients. The median overall survival (OS) was 24 months (95% confidence interval, 22–25), and the 5-year OS was 39%. Patients with extremity localisation had a 5-year OS of 49% compared with 29% in patients with a central tumour (P = 0.08). Patients with localised disease had a 5-year OS of 46%, whereas patients with metastatic disease had a 5-year OS of 29% (P = 0.12). Patients in SCR had a 5-year OS of 49%, whereas patients not in SCR had a 5-year OS of 23% (P = 0.004). Chemotherapy toxicity was considerable but manageable. There was no treatment-related death, and 39 (70%) patients received ≥6 cycles of the planned nine chemotherapy cycles. Conclusions: Adding intensive chemotherapy to surgery for treatment of DDCS is feasible and shows favourable survival data compared with previous reports. With the limitations of data from a non-controlled trial, we conclude that chemotherapy could be considered in the management of patients aged &gt;40 years.</p>}},
  author       = {{Hompland, Ivar and Ferrari, Stefano and Bielack, Stefan and Palmerini, Emanuela and Hall, Kirsten S. and Picci, Pierro and Hecker-Nolting, Stefanie and Donati, Davide M. and Blattmann, Claudia and Bjerkehagen, Bodil and Staals, Eric and Kager, Leo and Gambarotti, Marco and Kühne, Thomas and Eriksson, Mikael and Ferraresi, Virginia and Kevric, Matthias and Biagini, Roberto and Baumhoer, Daniel and Brosjø, Otte and Comandone, Alessandro and Schwarz, Rudolf and Bertulli, Rossella and Kessler, Torsten and Hansson, Lina and Apice, Gaetano and Heydrich, Björn N. and Setola, Elisabetta and Flörcken, Anne and Ruggieri, Pietro and Krasniqi, Fatime and Hofmann-Wackersreuther, Gerda and Casali, Paolo and Reichardt, Peter and Smeland, Sigbjørn}},
  issn         = {{0959-8049}},
  keywords     = {{Bone sarcoma; Chemotherapy; Complete surgical remission; Dedifferentiated chondrosarcoma; EURO-B.O.S.S.; Sarcoma; Survival; Systemic treatment}},
  language     = {{eng}},
  pages        = {{150--158}},
  publisher    = {{Elsevier}},
  series       = {{European Journal of Cancer}},
  title        = {{Outcome in dedifferentiated chondrosarcoma for patients treated with multimodal therapy : Results from the EUROpean Bone Over 40 Sarcoma Study}},
  url          = {{http://dx.doi.org/10.1016/j.ejca.2021.04.017}},
  doi          = {{10.1016/j.ejca.2021.04.017}},
  volume       = {{151}},
  year         = {{2021}},
}