[Experience with the surgical management of primary and secondary chondrosarcoma]

Forty eight primary and 20 secondary chondrosarcomas were treated surgically 1975 through 1991. An evaluation of the data of the Bone Tumor Register of the Semmelweis Medical University proved that the incidence of the malignant transformation and development of secondary chondrosarcomas is 3% and 2.6% among solitary osteochondromas. The authors summarize the clinicopathological characteristics of the malignant transformation. A retrospective evaluation of the histological grade of the malignancy proved that 67% of tumors were classified as grade I; 18% as grade II and 15% as grade III. The survival of the patients was mainly determined by the grade of the malignancy. A 95% 5-years survival was found in the grade I group and a 10% survival only in the grade II and III groups. In the cases of highly malignant chondrosarcomas radical surgical intervention i.e. amputation is recommended, considering the most often extra-compartmental location of the tumors. Low malignant and intra-compartmental highly malignant chondrosarcomas should be treated, however, by limb saving surgery. In the cases of large inresecable but low malignant chondrosarcomas debulking surgery is also acceptable.