Enhancing surgical margins: A key to survival in pelvic chondrosarcoma

Introduction: Pelvic chondrosarcoma, originating in the cartilaginous tissue of the pelvis, presents unique surgical challenges due to its proximity to critical neurovascular structures and essential organs. The aim of this study was to explore the effect of changes in practice and improvements in understanding on the outcomes for patients undergoing surgery for pelvic chondrosarcoma.

Material and methods: The study comprised a retrospective analysis of 216 patients making up 2 patient cohorts drawn from a single centre over 2 time periods (2003-2012 and 2013-2022).

Results: The results demonstrate significant improvements in disease-specific survival (DSS) and local recurrence-free survival (LRFS) in the modern cohort. Contributors to this improvement include the application of modern imaging techniques, the adoption of navigation, and improvements in tumour mapping. Despite these advancements, dedifferentiated chondrosarcoma remains a major challenge with poor survival outcomes.

Conclusion: The results of this study highlight the impact of modern surgical techniques, including navigation-assisted surgery, on improving the outcomes of patients with pelvic chondrosarcoma. Other contributory factors include improvements in imaging, multidisciplinary care, and a better understanding of disease specific factors, including adequate margins for resection, which have collectively contributed to better DSS and LRFS, particularly in patients with non-dedifferentiated tumours. However, the management of dedifferentiated chondrosarcoma remains an area of unmet need, and future research should focus on developing innovative therapeutic strategies for this aggressive subtype.