The cryosurgical treatment of chondroblastoma of bone: Long‐term oncologic and functional results

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

doi:10.1002/jso.20804

Cited by 37 publications

(33 citation statements)

References 19 publications

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“…Curettage is also used for the treatment of other benign cysts, and the question of whether adjuvants are necessary has also been raised for both aneurysmal bone cysts and chondroblastoma (Cottalorda and Bourelle 2006, van der Geest et al 2007). …”

Section: Discussionmentioning

confidence: 99%

Bone defects following curettage do not necessarily need augmentation

et al. 2009

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Background and purpose The natural pattern of bone healing in large bony defects following curettage alone as treatment of benign bone tumors around the knee is not well reported. We analyzed the outcome in 146 patients.Patients and methods 146 patients with over 18 months of follow-up who underwent curettage without bone substitute filling or bone grafting for a benign tumor in the distal femur or upper tibia were included. The mean diameter of the defects following curettage was 5.7 (1.3–11) cm and the estimated average volume was 63 (1–240) cm3. The plain radiographs before and following curettage were reviewed to establish the size of the initial defect and the rate of reconstitution and infilling of the bone. The time to full weight bearing and any complications were recorded.Results There was a variable rate of infilling; some defects completely reconstituted to a normal appearance while some never filled in. In 88% of the cases, no further intervention after curettage was required and the mean time to full weight bearing was 6 weeks. The risk of subsequent fracture or the late development of osteoarthritis was strongly related to the size of the cyst at diagnosis, with cysts of > 60 cm3 (about 5 cm in diameter) having a much higher incidence of complications.Interpretation This study demonstrates the natural healing ability of bone without any adjuvant filling. It could be used as a baseline for future studies using any sort of filling with autograft, allograft, or bone substitute.

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Section: Discussionmentioning

confidence: 99%

Bone defects following curettage do not necessarily need augmentation

et al. 2009

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“…However, local recurrence or metastases can occasionally occur. The quality of surgery remains the main prognostic factor for recurrence in these tumours [20]. Further studies are required to show whether ezrin expression could be predictive of recurrence or metastasis and also to elucidate the value of the membranous immunostaining in these tumours.…”

Section: Discussionmentioning

confidence: 99%

Ezrin immunohistochemical expression in cartilaginous tumours: a useful tool for differential diagnosis between chondroblastic osteosarcoma and chondrosarcoma

et al. 2008

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Ezrin is a cytoskeleton linker protein that is actively involved in the metastatic process of cancer cells. We have recently reported that ezrin expression in conventional osteosarcoma was an independent prognostic factor for event-free survival and overall survival. In this work, ezrin expression was found in all histological subtypes. Especially cartilaginous areas in chondroblastic osteosarcomas were immunopositive for ezrin. We wanted to know if ezrin could be a useful diagnostic marker in bone pathology. We have searched for ezrin expression in 208 cartilaginous tumours by immunohistochemistry and in 16 chondroblastic osteosarcomas. All conventional chondrosarcomas, whatever their grade, were negative, while ten of 16 chondroblastic osteosarcomas were positive. In contrast, dedifferentiated (five of 14) and mesenchymal chondrosarcomas (five of ten) showed ezrin positivity. Some chondroblastomas and more rarely chondromyxoid fibromas also exhibited ezrin expression. These data suggest that ezrin is a useful immunohistochemical marker for differential diagnosis between chondroblastic osteosarcomas and conventional chondrosarcomas with a specificity of 100%. Ezrin expression in dedifferentiated and mesenchymal chondrosarcomas which are aggressive neoplasms resistant to conventional treatment means that ezrin could be a therapeutic target. Ezrin expression in chondroblastomas is more intriguing and requires further study to assess prognostic value.

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“…Following recommended surgical treatments, the two- to three-year recurrence rate is as high as 10% to 20%, which may partially be due to wide application of inappropriate surgical methods [9,10]. IC, however, has been demonstrated to reduce local recurrence rates [9-11]. IC has been employed for the treatment of bone CBT, producing a recurrence rate of only 11% (2 out of 18) in one study [11].…”

Section: Introductionmentioning

confidence: 99%

“…IC, however, has been demonstrated to reduce local recurrence rates [9-11]. IC has been employed for the treatment of bone CBT, producing a recurrence rate of only 11% (2 out of 18) in one study [11]. In another study of 25 patients with a CBT, IC produced a recurrence rate of only 4.2% (1 out of 24) over an eight-year follow-up period [8].…”

Section: Introductionmentioning

confidence: 99%

Use of extended curettage with osteotomy and fenestration followed by reconstruction with conservation of muscle insertion in the treatment of Enneking stage II locally aggressive bone tumor of the proximal extremities: resection and treatment of bone tumors

et al. 2013

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BackgroundThe purpose of this study was to investigate the clinical efficacy of extended resection with osteotomy, fenestration and conservation of muscle (tendon) insertion in the treatment of bone tumors.MethodsA total of 15 patients with locally aggressive bone tumors (Enneking stage II) in the adjacent muscle (tendon) insertion of the proximal extremity were enrolled in the present study (mean age of 29 years). Extended curettage of lesions with osteotomy, fenestration and/or conservation of muscle (tendon) insertion and internal fixation with a bone graft or bone cement was performed at stage I. Postsurgical brace protection was used for 4 to 12 weeks and the patients were periodically followed-up by X-ray and functional assessment. Recurrence, postsurgical Enneking score and outcome rating were assessed.ResultsTreated cases included 15 patients aged 29 ±7.75 years (range, 18 to 42) with a male to female ratio of 8:7. Six had a femoral tumor and nine had a humeral tumor. These tumors comprised three chondroblastomas, five giant-cell tumors and seven aneurysmal bone cysts. Follow-up for 48 ±12.95 months (range, 25 to 72) revealed that 13 of 15 (87%) patients exhibited no recurrence. Local recurrence was observed in a patient with an aneurysmal bone cyst (nine months) and one with a giant-cell tumor (12 months). Mean Enneking scores were 27 ±4.07 (range, 18 to 29). Except for the patient with the recurrent giant-cell tumor, all patients reported good (13%, 2 out of 15) or very good (80%, 12 out of 15) outcomes. Very good outcomes were reported in 92% of patients (12 out of 13) without recurrence.ConclusionsThe procedures used in this study achieved high clinical efficacy, complete lesion removal, reduced recurrence and good restoration of joint function in patients with primary locally aggressive Enneking stage II bone tumors of the proximal extremities.

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The cryosurgical treatment of chondroblastoma of bone: Long‐term oncologic and functional results

Abstract: Chondroblastoma of bone is a benign tumor with a relatively high recurrence rate. The local recurrence rates can be decreased with cryosurgery as a local adjuvant therapy with excellent functional results.

Cited by 37 publications

References 19 publications

Bone defects following curettage do not necessarily need augmentation

Bone defects following curettage do not necessarily need augmentation

Ezrin immunohistochemical expression in cartilaginous tumours: a useful tool for differential diagnosis between chondroblastic osteosarcoma and chondrosarcoma

Use of extended curettage with osteotomy and fenestration followed by reconstruction with conservation of muscle insertion in the treatment of Enneking stage II locally aggressive bone tumor of the proximal extremities: resection and treatment of bone tumors

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