Sex-based differences in disease-specific survival among patients with chondrosarcoma: A population-based cohort study

BACKGROUND: To evaluate whether sex-based differences in disease-specific survival vary across age-defined reproductive groups among patients with chondrosarcoma using a large national cancer registry. METHODS: We analyzed 3762 chondrosarcoma patients (1973-2015) from the Surveillance, Epidemiology, and End Results (SEER) database. Women were categorized as premenopausal (31-50, n = 808) or postmenopausal (51-70, n = 870). Men were similarly categorized as younger men (n = 983, 26.1%) aged 31-50 years, or older men (n = 1101, 29.3%) aged 51-70 years. Patients outside the 31-70 age range were excluded to minimize confounding by extreme age-related mortality risk and to focus on hormonally relevant groups. Data included demographics, tumor grade, tumor size, tumor stage, location, surgery, and survival. Tumor size was missing in 54.8% of patients, tumor stage in 48.1%, and tumor grade in 17.2%. Analyses included Chi-square tests, Kaplan-Meier estimates, and Cox models. RESULTS: Premenopausal women more frequently had more low-grade tumors (43.2% vs. 31.2%; p < 0.05) and higher 5- and 10-year disease-specific survival for dedifferentiated chondrosarcoma (68% and 63% vs. 36% and 36%; p < 0.05). Premenopausal women had better 5- and 10-year survival (93% and 88% vs. 83% and 76%; p < 0.0001) and overall disease-specific survival (92% and 88% vs. 81% and 74%; p < 0.0001). Younger men had a higher death risk (HR 2.45; 95% CI, 1.83-3.29; p < 0.001). CONCLUSION: Premenopausal women were associated with improved disease-specific survival, these findings suggest that sex-related biological differences may influence survival in chondrosarcoma and warrant further investigation into potential hormonal mechanisms.