KEY TAKEAWAYS
- The study aimed to analyze differences in clinical, molecular, therapeutic, and prognostic factors among spinal chondrosarcoma subtypes.
- The results showed upregulated p53/MDM2 pathway in MCS and DCS, with radical resection crucial for spinal chondrosarcoma.
Spinal chondrosarcoma is more invasive and has a worse prognosis than extremity chondrosarcoma. Prognosis and treatment vary among chondrosarcoma subtypes.
Jian Sun and the team aimed to analyze the clinical characteristics, molecular features, therapeutic effects, and prognostic factors among the subtypes of spinal chondrosarcoma.
A retrospective review of 205 patients with spinal chondrosarcoma was conducted. Researchers compared clinical features and immunohistochemical (IHC) markers among pathological subtypes including chondrosarcoma grade 1, grade 2, grade 3, mesenchymal chondrosarcoma (MCS), dedifferentiated chondrosarcoma (DCS), and clear cell chondrosarcoma (CCCS).
Chondrosarcoma grades 1/2/3 were collectively referred to as conventional chondrosarcoma (CCS) for multivariate analysis. Univariate and multivariate analyses investigated independent prognostic factors for OS and RFS in spinal chondrosarcoma. They also identified independent prognostic factors for OS and RFS in CCS and MCS.
Patients with MCS were younger than other subtypes. Patients with chondrosarcoma grade 1/2 had better OS than those with chondrosarcoma grade 3, MCS and DCS. Only those with grade 1 showed better RFS than grade 2/3, MCS and DCS patients. Ki-67 index was higher in chondrosarcoma grade 3, MCS and DCS than chondrosarcoma grade 1/2.
The IHC marker comparison highlighted P53/MDM2 overexpression in MCS and DCS. Gross total resection, including en bloc and piecemeal resection, significantly improved OS and RFS in CCS, while only en bloc resection significantly improved the prognosis of MCS patients. Chemotherapy appeared important for the OS of MCS patients.
The P53/MDM2 pathway was upregulated in MCS and DCS compared to chondrosarcoma grade 1/2. Radical tumour resection is crucial for treating spinal chondrosarcoma, while MCS patients require further comprehensive perioperative treatments.
Funding support was provided by the National Natural Science Foundation of China.
Source: https://link.springer.com/article/10.1007/s11060-024-04823-y
Sun J, Wu Z, Jiao J, et al. (2024). “Comparisons of clinical characteristics, treatments, and outcomes among different pathological subtypes of chondrosarcoma in the spine. J Neurooncol.” 2024. Available at: https://doi.org/10.1007/s11060-024-04823-y.
