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  • Title: Proximal humerus chondrosarcoma.Long-term clinical and oncological outcomes.
    Author: Albergo JI, Farfalli Luis GL, Ayerza MA, Muscolo DL, Aponte-Tinao LA.
    Journal: Rev Esp Cir Ortop Traumatol (Engl Ed); 2019; 63(3):181-186. PubMed ID: 30914237.
    Abstract:
    INTRODUCTION: The proximal humerus is a common site for primary bone sarcomas, of which chondrosarcoma represents 15%. There are few reports about this select group of tumours. We set out to analyse a group of patients with proximal humerus chondrosarcoma treated with surgery and to assess their long term surgical and oncological outcomes. MATERIAL AND METHODS: A retrospective review was performed and all patients with a proximal humerus chondrosarcoma treated with surgery were included in the study. Overall survival and local recurrence rates were analyzed. Post-operative complications were recorded and limb salvage surgery failures classified according to the Henderson classification. RESULTS: 37 patients were included in the study. The median age was 46 years (SD: 15.6, range: 17-24), 24 (65%) were female and the mean follow-up was 8.5 years (SD: 6.4, range: 2 -26). Eighteen patients were classified as grade 1 (49%), 15 as grade 2 (40%), 2 as grade 3 (5%) and 2 dedifferentiated chondrosarcomas (5%). The 10-year overall survival was 94.5% and the 10-year event-free survival was 84.5%. Five patients developed local recurrences (13%) and none of them was grade 1. The reconstruction failure rate was 27% at 5 years and 34% at 10 years. There were no complications or local recurrence in patients treated with curettage. CONCLUSION: Proximal humerus chondrosarcoma presented high survival rates. Curettage and bone grafting is a safe procedure, with low risk of complications and local recurrence for grade 1 chondrosarcomas and should be the first indication for the proximal humerus. Reconstruction of the proximal humerus after a wide resection has a 5-year failure rate of 27% and 10-year failure rate of 34%.
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