Epidemiological Analysis of Malignant Bone and Cartilage Tumors in the Hand With Focus on Chondrosarcoma: A Twenty-year Study with a Focus on Surgical Treatment Outcomes.
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BACKGROUND/AIM: Malignant bone and cartilage tumors of the hand are rare and complex, significantly affecting patient quality of life. This study examined the epidemiology and surgical outcomes of these patients with a focus on chondrosarcoma as well as the critical role of surgery. PATIENTS AND METHODS: A population-based study was performed by analyzing data from the Surveillance, Epidemiology, and End Results (SEER) database, covering all hand-related bone and cartilage malignant tumors from 22 registries between 2000 and 2020. Descriptive analysis characterized demographic and pathophysiological features. Overall survival (OS) was assessed using the log-rank test. Multivariable Cox regression identified independent prognostic factors. RESULTS: The study involved 315 patients [163 (51.75%) females, average age 45.83±22.41 years], with chondrosarcoma being the most prevalent diagnosis (52.06%), followed by osteosarcoma, giant cell tumor, and Ewing sarcoma. Most tumors were right-hand localized (55.56%) and at a localized stage (45.08%). Surgical intervention was performed in 72.06% of cases, with survival rates starting at 96.37% at one year and declining to 60.56% at twenty years. In chondrosarcoma cases, radical surgery demonstrated notably better outcomes with no deaths, significantly outperforming amputation (p=0.018). Survival differences based on surgical approach were statistically significant in localized chondrosarcoma (p=0.012), particularly with radical surgery showing the highest survival for localized Grade I and II tumors (p=0.034). Multivariate analysis highlighted age, higher tumor grade, and advanced stage as predictors of worse outcomes, whereas radical surgery consistently predicted better survival compared to amputation. CONCLUSION: Early and aggressive surgical management for enhancing patient survival is essential, particularly in cases of localized and low-grade chondrosarcomas. The findings highlight the need for ongoing research on new treatment strategies seeking to improve outcomes for these rare but impactful tumors.