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Chondrosarcoma

Guidelines

Key sources

The following summarized guidelines for the evaluation and management of chondrosarcoma are prepared by our editorial team based on guidelines from the European Reference Network on Genetic Tumour Risk Syndromes (GENTURIS/ERN PaedCan/EURACAN/ESMO 2021), the National Comprehensive Cancer Network (NCCN 2021), and the Spanish Group for Research on Sarcomas (GEIS 2017). ...
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Diagnostic investigations

History and physical examination: as per ERN PaedCan/ESMO/EURACAN/GENTURIS 2021 guidelines, elicit medical history and perform physical examination in the initial work-up of patients with suspected primary bone sarcoma.
B
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  • Imaging for staging

Diagnostic procedures

Biopsy and pathology: as per ERN PaedCan/ESMO/EURACAN/GENTURIS 2021 guidelines, perform biopsy in the initial work-op of patients with suspected primary bone sarcoma.
B
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Medical management

Setting of care: as per ERN PaedCan/ESMO/EURACAN/GENTURIS 2021 guidelines, manage patients with bone sarcomas at reference centers and/or within reference networks able to provide access to the full spectrum of care and age-specific expertise.
B

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  • Chemotherapy

  • Management of metastatic disease

  • Management of recurrent disease

Therapeutic procedures

Radiotherapy
As per ERN PaedCan/ESMO/EURACAN/GENTURIS 2021 guidelines:
Consider offering radiotherapy in patients with primary unresectable disease, after incomplete surgery and for symptoms palliation.
C
Offer high-dose radiotherapy in patients with skull base chondrosarcomas.
B

Surgical interventions

Wide-local excision: as per ERN PaedCan/ESMO/EURACAN/GENTURIS 2021 guidelines, perform surgical excision with wide margins in patients with high-grade chondrosarcomas and all chondrosarcomas of the pelvis or axial skeleton.
B

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  • Intralesional excision

Specific circumstances

Patients with mesenchymal chondrosarcoma: as per NCCN 2021 guidelines, treat patients with mesenchymal chondrosarcoma as Ewing's sarcoma.
B

Patient education

Genetic counseling: as per NCCN 2021 guidelines, consider referring selected patients with chondrosarcoma for genetic consultation and testing based on family history with a genetic predisposition for bone sarcomas.
C

Follow-up and surveillance

Surveillance: as per ERN PaedCan/ESMO/EURACAN/GENTURIS 2021 guidelines, consider obtaining follow-up approximately every 3 months for the first 2 years, every 6 months for years 3-5, every 6-12 months for years 5-10, and every 0.5-1-2 years thereafter.
C
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