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.

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.