The prognostic significance of different histomorphologic features in chondrosarcoma

Cellularity, mitotic rate and nuclear size were determined objectively in 47 chondrosarcomas. Grading was also performed, according to the systems of O'Neal and Ackerman and of Evans. The survival rate and incidence of metastases 10 years after diagnosis were calculated. The prognostic significance of the objectively determined cytological parameters was investigated. The accuracy of determination of these cytological parameters by grading (Evans) was also analyzed. Nuclear size seemed to be the best prognostic parameter, while cellularity appeared to be the strongest determinant for grading. Gross differences of nuclear size can be assessed visually, while more subtle, although prognostically significant, differences can only be determined by objective means. The results of this study indicate that the mere determination of nuclear size by objective means may give significant prognostic information, which is equal to, or even better than, conventional grading of chondrosarcoma.