Survival and functional outcomes in surgically treated pelvic chondrosarcoma: a retrospective single-center cohort study

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Background Pelvic chondrosarcoma is a rare malignant bone tumor associated with challenging surgical management, high morbidity, and variable oncological outcomes. Because of its rarity, prognostic factors and functional outcomes remain insufficiently characterized. This study evaluated survival, prognostic factors, complications, and functional outcomes following surgical treatment of primary and locally recurrent pelvic chondrosarcoma. Methods We retrospectively analyzed 54 consecutive patients who underwent surgery for primary pelvic chondrosarcoma ( n = 37) or locally recurrent disease ( n = 17) at a single tertiary musculoskeletal oncology center between 2007 and 2020. Patients undergoing surgery for metastatic pelvic lesions were excluded. Overall survival was estimated using the Kaplan–Meier method. Univariable Cox regression analyses and an exploratory multivariable model including age and tumor grade were performed. Functional outcome was assessed using the Musculoskeletal Tumor Society (MSTS) score. Results The mean clinical follow-up was 31.7 months. During follow-up, 22 patients died. Estimated overall survival was 80.3% at 1 year (95% CI 65.4–89.3%), 65.1% at 3 years (95% CI 48.6–77.4%), and 48.8% at 5 years (95% CI 30.6–64.8%). Increasing age was independently associated with a higher hazard of death (adjusted HR per year, 1.048; 95% CI, 1.014–1.083; p = 0.0052); tumor grade also showed an association (adjusted HR per grade, 1.802; 95% CI, 1.006–3.228; p = 0.0476). Functional outcome was available for 27 patients, with a mean MSTS score of 11.6 ± 5.8. Revision surgery was required in 38 patients (70.4%). Conclusions: Surgical treatment of pelvic chondrosarcoma is associated with considerable morbidity and impaired functional outcome. In this cohort, age and tumor grade were associated with overall survival in an exploratory model. These findings should be interpreted in light of the retrospective design, limited cohort size, and relatively short follow-up. Clinical trial number not applicable.