TY  - BOOK
AU  - Henshaw, Robert M
AU  - Lynce, Filipa
AU  - Schult, Patricia
TI  - Long-term results of intralesional curettage and cryosurgery for treatment of low-grade chondrosarcoma
KW  - *Bone Neoplasms/su [Surgery]
KW  - *Chondrosarcoma/su [Surgery]
KW  - *Cryosurgery
KW  - *Curettage
KW  - Adult
KW  - Aged
KW  - Bone Neoplasms/pa [Pathology]
KW  - Chondrosarcoma/pa [Pathology]
KW  - Cryosurgery/mt [Methods]
KW  - Fractures, Spontaneous/ep [Epidemiology]
KW  - Humans
KW  - Middle Aged
KW  - Neoplasm Recurrence, Local/ep [Epidemiology]
KW  - Retrospective Studies
KW  - Treatment Outcome
KW  - Young Adult
KW  - MedStar Washington Hospital Center
KW  - Washington Cancer Institute
KW  - Orthopedic Oncology
KW  - Journal Article
N2  - BACKGROUND: Data regarding outcomes following intralesional curettage and cryosurgical treatment of low-grade chondrosarcoma of bone are limited. The aim of this study was to assess the long-term oncologic and functional outcomes of two different cryosurgery techniques; CONCLUSIONS: Intralesional curettage and cryosurgery for low-grade chondrosarcoma is safe and effective in selected patients. The presence of preoperative cortical breakthrough and soft-tissue extension was the strongest predictor of local recurrence following use of this technique; LEVEL OF EVIDENCE: Therapeutic level IV. See instructions for authors for a complete description of levels of evidence; METHODS: Forty-three low-grade chondrosarcoma lesions (in forty-two patients) were treated with intralesional curettage and cryosurgery from June 1983 to October 2006. Eleven lesions were treated with cryoprobes and thirty-two were treated with the modified direct-pour Marcove technique. The mean patient age was 44.9 +/- 11.3 years (range, 21.8 to 66.4 years), and the mean duration of follow-up was 10.2 +/- 4.6 years (range, five to 22.5 years). Indications for treatment included a radiographic appearance consistent with a cartilage tumor with evidence of aggressive behavior. Pearson correlation and multivariate analyses were used to evaluate the relationships between predictive factors (including lesion size, soft-tissue extension, and location, patient age, cortical erosion, and presence of preoperative pain) and outcomes; RESULTS: The mean overall Musculoskeletal Tumor Society (MSTS) score was 26.5 +/- 3.1 (range, 17 to 30). There were four local recurrences, all in patients who had had tumor extension out of the bone with soft-tissue involvement at initial presentation. The mean time to recurrence was 2.4 +/- 2.3 years (range, 0.6 to 5.6 years). No patients developed metastatic disease during the follow-up period. There were no differences between the cryoprobe and Marcove techniques with respect to the MSTS score, fracture, or local recurrence. A significant correlation between tumor recurrence and soft-tissue extension was found (r = 0.79). Kaplan-Meier survivorship, with freedom from recurrence as the end point, was 90.7%
UR  - http://dx.doi.org/10.2106/JBJS.L.00442
ER  -