Age ≥75 with ECOG ≥2 or ≥2 comorbidities — wide en-bloc bone resection with reconstructio...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-CHONDROSARCOMA-FRAILTY-AGE`
Type	Red flag
Status	reviewed 2026-04-26 \| pending_clinical_signoff
Diseases	`DIS-CHONDROSARCOMA`
Sources	`SRC-NCCN-NSCLC-2025` `SRC-ONCOKB`

Red Flag Origin

Definition	Age ≥75 with ECOG ≥2 or ≥2 comorbidities — wide en-bloc bone resection with reconstruction and doxorubicin-based regimens for dedifferentiated subtype poorly tolerated; consider intralesional curettage for low-grade lesions, omission of chemotherapy in dedifferentiated subtype, or palliative RT only.
Clinical direction	de-escalate
Category	frailty-age

Trigger Logic

{
  "all_of": [
    {
      "comparator": ">=",
      "finding": "age_years",
      "threshold": 75
    },
    {
      "any_of": [
        {
          "comparator": ">=",
          "finding": "ecog_status",
          "threshold": 2
        },
        {
          "comparator": ">=",
          "finding": "comorbidity_count",
          "threshold": 2
        }
      ]
    }
  ],
  "type": "composite_clinical"
}

Notes

Conventional chondrosarcoma is chemotherapy-resistant — frailty rarely changes 1L systemic therapy because there is none. The decision matters most for dedifferentiated subtype where doxorubicin ± ifosfamide is offered (extrapolated from soft-tissue sarcoma data); cardiac toxicity and pancytopenia rates climb with age. Surgical morbidity from en-bloc resection of pelvic / axial lesions is also high in elderly — consider IDH-targeted therapy trial enrollment (ivosidenib for IDH1 R132 mutants) over conventional chemo. Source-gap caveat: NCCN Bone Cancer / ESMO Bone Sarcomas not yet ingested as separate Source entities — using SRC-NCCN-NSCLC-2025 (per disease YAML precedent) and SRC-ONCOKB.

Used By

No reverse references found in the YAML corpus.