Oncological and functional results of cryosurgical therapy of enchondromas and chondrosarcomas grade 1

Geest, I.C.M. van der; Valk, M.H. de; Rooy, J.W.J. de; Pruszczyński, M; Veth, R.P.H.; Schreuder, H.W.B.

doi:10.1002/jso.21122

Cited by 61 publications

(44 citation statements)

References 30 publications

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“…Van der Geest et al reported a rate of 14% in a series of 130 enchondromas and Grade I chondrosarcomas, six fractures in the proximal humerus and 12 in the distal femur [30]. In their series [30], prophylactic internal fixation was used in only 11 of 130 cases when it was systematic in our series, which had no fractures at the same anatomic sites. A second explanation could be the simplified technique we used obtained frozen margins probably inferior to the 15-mm thickness estimated by Van der Geest et al [30] or the 7 to 12 mm observed in a dog model by Malawer et al [16].…”

Section: Discussionmentioning

confidence: 50%

“…The risk of fracture was reported from 1% (four of 440) by Meller et al [19] to 20% by Marco et al [17]. Van der Geest et al reported a rate of 14% in a series of 130 enchondromas and Grade I chondrosarcomas, six fractures in the proximal humerus and 12 in the distal femur [30]. In their series [30], prophylactic internal fixation was used in only 11 of 130 cases when it was systematic in our series, which had no fractures at the same anatomic sites.…”

Section: Discussionmentioning

confidence: 98%

“…We identified no patients with air embolism or nerve palsy. The rate reported in a recent comparative study is approximately 2% for those two last complications [30]. It is crucial when choosing the surgical approach to avoid neurovascular structures.…”

Section: Discussionmentioning

confidence: 99%

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No Recurrences in Selected Patients after Curettage with Cryotherapy for Grade I Chondrosarcomas

Souna

Belot

Duval

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background The low aggressiveness of Grade I chondrosarcomas is compatible with conservative surgical treatment. Questions/purpose We asked whether combined curettage and cryotherapy would yield low rates of recurrence and whether supplemental internal fixation would retain function with low rates of complications in patients with Grade I central chondrosarcomas of the proximal humerus or distal femur. Methods We retrospectively reviewed 15 patients: nine women and six men with a mean age of 45 years (range, 26-70 years). All patients underwent curettage and cryosurgery through a cortical window; we replaced the window and plated the region with at least three screws beyond the curetted area. None of the patients was lost to followup, and 14 patients (93%) were reexamined by us after a minimum of 5 years (mean, 8 years; range, 5-11 years). Results There were no perioperative anesthetic, neurologic, hardware, or healing complications. None of the patients had local recurrence or metastases develop. At last followup, the Musculoskeletal Tumor Society score was 27.9 (range, 22-30) and all patients had resumed their previous activities. No complications were associated with this simplified cryotherapy technique. Conclusions The data confirm the appropriateness of conservative surgery for central low-grade chondrosarcomas of the proximal humerus and distal femur based on a combination of intralesional curettage and cryogenic parietal sterilization. Candidates for this approach should be chosen on the basis of the affected bone site, local extension staging, and clinicopathologic grading. We recommend supplementary internal fixation.

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Section: Discussionmentioning

confidence: 50%

Section: Discussionmentioning

confidence: 98%

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No Recurrences in Selected Patients after Curettage with Cryotherapy for Grade I Chondrosarcomas

Souna

Belot

Duval

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…When adjuvants such as cryosurgery, phenol, and methylmethacrylate are used in combination with curettage in treating benign or low-grade malignant tumors, the local recurrence rates are reportedly as low as 0.0% to 6.0% [1-3, 16, 21, 27, 30, 31]. In the largest published series of patients with enchondromas and Grade 1 chondrosarcomas treated with curettage and cryosurgery, van der Geest et al [31] reported on 123 patients with an average followup of 60 months. Two (1.6%) patients had local recurrences, both of whom were treated with repeat surgery and reportedly were disease-free at 3 and 5 years.…”

Section: Discussionmentioning

confidence: 99%

“…We chose 18 months as a minimum followup based on the median time to local recurrence reported in similar studies [1,4,6,14,17,30,31]. Of the 68 patients, 46 (68%) had at least 18 months followup.…”

Section: Methodsmentioning

confidence: 99%

Curettage and Cryosurgery for Low-grade Cartilage Tumors Is Associated with Low Recurrence and High Function

Mohler

Chiu

McCall

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Chondrosarcomas of bone traditionally have been treated by wide or radical excision, procedures that may result in considerable lifelong disability. Grade 1 chondrosarcomas have little or no metastatic potential and are often difficult to distinguish from painful benign enchondromas. Curettage with adjuvant cryosurgery has been proposed as an alternative therapy for Grade 1 chondrosarcomas given the generally better function after the procedure. However, because it is an intralesional procedure, curettage and cryosurgery may be associated with higher rates of recurrence. Questions/purposes We asked whether Grade 1 chondrosarcomas and enchondromas of uncertain malignant potential treated by curettage and cryosurgery are associated with low recurrence rates and high functional scores. Patients and Methods We retrospectively reviewed the records of 46 patients with Grade 1 chondrosarcomas and enchondromas of uncertain malignant potential treated by curettage and cryosurgery. Forty-one patients had tumors of the long bones. Patients were followed a minimum of 18 months (average, 47.2. months; range, 18-134 months) for evidence of recurrence and for assessment of Musculoskeletal Tumor Society (MSTS) functional score.

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Intralesional treatment versus wide resection for central chondrosarcoma grade I in the long bones

Dierselhuis

Stevens

Jutte

2013

Cochrane Database of Systematic Reviews

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Oncological and functional results of cryosurgical therapy of enchondromas and chondrosarcomas grade 1

Abstract: Curettage and cryosurgery for enchondroma and chondrosarcoma grade 1 has excellent oncological and functional results. The post-operative management has been adjusted to reduce the number of fractures.

Cited by 61 publications

References 30 publications

No Recurrences in Selected Patients after Curettage with Cryotherapy for Grade I Chondrosarcomas

No Recurrences in Selected Patients after Curettage with Cryotherapy for Grade I Chondrosarcomas

Curettage and Cryosurgery for Low-grade Cartilage Tumors Is Associated with Low Recurrence and High Function

Intralesional treatment versus wide resection for central chondrosarcoma grade I in the long bones

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