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Oncologic and Functional Outcome of Scapular Chondrosarcoma

¹ University Musculoskeletal Oncology Unit at Mount Sinai Hospital, The University of Toronto, Suite 476G, 600 University Avenue, Toronto, Canada M5G 1X5
² Department of Surgical Oncology at Mount Sinai Hospital and Princess Margaret Hospital, The University of Toronto, Toronto, Canada
³ Department of Surgery, The University of Toronto, Toronto, Canada

Correspondence: Address correspondence and reprint requests to: Peter C. Ferguson, MD FRCSC; E-mail: pferguson{at}mtsinai.on.ca

Background: The scapula is a common site for chondrosarcoma to occur. There has been disagreement between recent studies documenting the oncologic outcomes in patients with chondrosarcoma of the scapula. The purpose of this study was to investigate both the oncologic and functional outcomes of patients presenting to a large oncology center with primary chondrosarcoma of the scapula.

Methods: A review of our prospectively collected database was carried out. All patients in the years 1989 to 2004 undergoing surgical resection of primary chondrosarcoma of the scapula were included. We documented patient demographics, whether the patient underwent partial or total scapulectomy, oncologic outcomes including local and systemic recurrence, and functional outcome using the Musculoskeletal Tumor Society (MSTS) 87, MSTS 93, and Toronto Extremity Salvage Score (TESS) rating systems.

Results: Twenty-four patients (16 males, 8 females), with a mean age of 44 years (range 18–74 years), met the inclusion criteria. There were no local recurrences. Two patients died of metastatic disease at 23 and 103 months postoperatively. No other patients have developed systemic disease. Sixteen patients underwent partial scapulectomy while eight underwent total scapulectomy. Functional outcome was better in the group undergoing partial scapulectomy with significantly higher MSTS 87 (30.8 versus 16.6), MSTS 93 (89.6 versus 68.3), and TESS (92.6 versus 74.9) scores than the total scapulectomy group.

Conclusion: Patients with primary chondrosarcoma of the scapula have an excellent oncologic prognosis with a very low local recurrence and metastatic rate. Functional outcomes are better for patients undergoing partial rather than total scapulectomy.

Key Words: Chondrosarcoma • Scapula • Functional outcome • Surgery