Chondrosarcoma

Chondrosarcoma is a primary cancer of bone. It is an extremely rare disease as it affects 1 in 2.5 lac people per year. It is second most common primary cancer of bone after osteosarcoma. It is most common in the age group of 50 years or more and the commonest location is pelvic bones i.e the bone which connects lower extremities to the spine. However, it can affect any bone and any age group of patient.

In majority, the exact cause of Chondrosarcoma is unknown. However, it has been linked to genetic mutations, some pre-existing lesions in bone like enchondroma, osteochondroma and chondroblastoma from which it can transform into chondrosarcoma.

It is diagnosed with the help of Xray, MRI and a needle biopsy – histopathology.

Once diagnosed, its staging is done. Staging means, to find out whether it has spread to any other part of body or not? For that, typically a CT scan of chest and a bone scan is done. However, with advent and availability of PET CT scans, even that can be done.

Following are the stages of Chondrosarcoma in simple terms.

Stage 1: Low grade Chondrosarcoma (i.e. the cancer is not very aggressive)

Stage 2: High grade Chondrosarcoma (i.e. the cancer is very aggressive) but has not spread within the same bone (skip lesion) or to any other part of the body

Stage 3: High grade Chondrosarcoma which has spread within the same bone (skip lesion) but hasn’t spread to other organs or nearby lymphnodes

Stage 4: Chondrosarcoma which has spread to nearby lymphnodes or to distant organs like lung, liver brain or other bones

The treatment of Chondrosarcoma consists of only a surgery. It is a cancer which is resistant to chemotherapy and radiotherapy.

About 3 decades ago, only surgery offered to the patient of Chondrosarcoma was amputation, i.e. removing the whole leg. In today’s era, a specialized type of “limb salvage surgery” is offered to the patient, i.e. the tumor is removed but the limb id saved. With this type of surgery, patient remains near normal and functional.

Very few patients with specific variants of chondrosarcoma like mesenchymal chondrosarcoma / De-differentiated chondrosarcoma may need to receive chemotherapy.

It depends on the stage of presentation. After optimum treatment, following are the chances of cure from Chondrosarcoma

1	Stage 2	90%
2	Stage 2	65%
3	Stage 3	10 – 15%
4	Stage 4	< 2 %

Once the treatment is over, patient needs to follow up on regular bases irrespective of any problems for next 10 years. It is only then, that the patient is declared free of cancer!

1	For first 2 years	3 monthly
2	For next 3 years	6 monthly
3	For next 5 years	1 yearly