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

• Published in: Journal of surgical oncology Vol. 98; no. 6; pp. 421 - 426
• Main Authors: van der Geest, I.C.M., de Valk, M.H., de Rooy, J.W.J., Pruszczynski, M., Veth, R.P.H., Schreuder, H.W.B.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-11-2008
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Bone Cements - therapeutic use; Bone Neoplasms - pathology; Bone Neoplasms - surgery; Bone Plates; Bone Transplantation; bone tumor; chondroid tumor; Chondroma - pathology; Chondroma - surgery; Chondrosarcoma - pathology; Chondrosarcoma - surgery; Cryosurgery; Curettage; Female; Follow-Up Studies; Humans; limb salvage; Male; Middle Aged; Neoplasm Recurrence, Local - surgery; Postoperative Complications
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.21122

Background and Objectives
Cryosurgery using liquid nitrogen is used as adjuvant treatment after intralesional resection of bone tumours to induce cell death. It is applied to enlarge the oncological margins of resection and to reduce the local recurrence rate. The objective of this study is to analyze the oncological and functional results.
Methods
We studied the oncological and functional results of curettage and cryosurgery in 123 patients with 130 tumors. There were 75 enchondromas and 55 chondrosarcomas grade 1. The minimal follow‐up period for all patients was 2 years (range 24–119 months).
Results
During follow‐up one local recurrence of an active enchondroma and one local recurrence of an aggressive enchondroma occurred. They were treated with curettage and cryosurgery again. Both patients were disease‐free at minimum of 3 years follow‐up. No local recurrences after treatment of chondrosarcoma grade 1 were seen. Functional scores, according to the MSTS scoring system, showed an average score of 28 points (94%) at 2 years follow‐up. Post‐operative fractures were seen in 18 patients (14%).
Conclusions
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. J. Surg. Oncol. © 2008 Wiley‐Liss, Inc.