# Outcomes and Management of Positive Margins in Chondrosarcoma With Soft Tissue Extension: A Case Series and Review of Literature

## TL;DR

This study examines outcomes of chondrosarcoma patients with soft tissue extension and positive surgical margins, finding a high recurrence rate and suggesting the need for closer monitoring.

## Contribution

The paper identifies a high-risk subgroup of chondrosarcoma patients with both soft tissue extension and positive margins, highlighting the need for tailored treatment strategies.

## Key findings

- Patients with both soft tissue extension and positive margins had a 50% recurrence rate within 10 months.
- 83.3% of patients in the study were alive at the end of the follow-up period.
- The study suggests this subgroup has worse outcomes than those with only one risk factor.

## Abstract

Chondrosarcoma accounts for 20% of all bone sarcomas and may present with soft tissue extension. The presence of an extraosseous component, along with positive surgical margins, independently have been associated with increased risk of local recurrence and decreased survival. The purpose of this investigation is to describe the treatment and outcomes of six chondrosarcoma patients who presented with chondrosarcoma with soft tissue extension along with positive surgical margins post negative en bloc resection.

This was a retrospective review over a consecutive 13‐year period. Data including treatment details and outcomes were included. All patients underwent attempted negative margin en bloc resection and encountered unplanned positive margins on intraoperative determination or postoperative pathology (R1). A total of six cases were identified. Average age (SD) was 61.8 years (6.11) with median (IQR) follow‐up of 17.0 months (10.3–39.5). Three (50.0%) cases arose in the extremities, and 3 (50.0%) cases in the pelvis. All patients underwent attempted negative margin en bloc resection. Three (50.0%) cases recurred with median (IQR) time to recurrence of 10.0 months (9.0–31.0). At study conclusion, 5 (83.3%) were alive with median (IQR) survival of 20.5 months (11.3–41.0).

Despite limited sample size, our data reflected a significantly higher recurrence rate compared to either chondrosarcomas with positive margins or extraosseous extension. Our cohort represents a high‐risk subgroup of chondrosarcoma patients, which may dictate increased monitoring and guide future treatment recommendations for these patients.