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A Systematic Review and Meta-analysis of Intralesional Versus Wide Resection for Intramedullary Grade I Chondrosarcoma of the Extremities

  • Bone and Soft Tissue Sarcomas
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The surgical management of grade I intramedullary chondrosarcoma of bone remains controversial. The purpose of this study was to perform a systematic review and meta-analysis of published data to determine the oncologic outcomes of intralesional versus wide resection for grade I intramedullary chondrosarcoma.

Methods

Literature searches were performed through Medline, EMBASE, and the Cochrane Database. Cohort studies in which one patient group with grade I chondrosarcoma underwent wide resection and one underwent intralesional curettage were included. Two reviewers independently assessed all eligible papers with the Newcastle-Ottawa Quality Assessment Scale for Cohort Studies. The outcome measures were the pooled odds ratio and 95% confidence intervals for the risk of local recurrence and metastasis calculated through the random-effects method.

Results

Five eligible studies were identified including a total of 190 patients, 78 of whom underwent intralesional resection and 112 of whom underwent wide resection. Only one pelvic lesion was identified, which underwent wide resection. There were a total of five local recurrences and three metastases. The risk for local recurrence and metastasis did not differ significantly between the two groups, with an odds ratio for intralesional resection of 2.26 (95% confidence interval, 0.41–12.62) and 0.44 (95% confidence interval, 0.04–5.21) respectively.

Conclusions

Intralesional curettage as an alternative to wide resection for extrapelvic grade I chondrosarcoma of bone does not greatly increase the risk for local recurrence or metastasis. Overall effect estimates, however, should be interpreted with caution as a result of the relatively small number of events.

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References

  1. Giuffrida AY, Burgueno JE, Koniaris LG, et al. Chondrosarcoma in the United States (1973 to 2003): an analysis of 2890 cases from the SEER database. J Bone Joint Surg Am. 2009;91:1063–72.

    Article  PubMed  Google Scholar 

  2. Rizzo M, Ghert MA, Harrelson JM, Scully SP. Chondrosarcoma of bone: analysis of 108 cases and evaluation for predictors of outcome. Clin Orthop Relat Res. 2001:224–33.

  3. York JE, Berk RH, Fuller GN, et al. Chondrosarcoma of the spine: 1954 to 1997. J Neurosurg. 1999;90:73–8.

    PubMed  CAS  Google Scholar 

  4. Lee FY, Mankin HJ, Fondren G, et al. Chondrosarcoma of bone: an assessment of outcome. J Bone Joint Surg Am. 1999;81:326–38.

    Article  PubMed  CAS  Google Scholar 

  5. Riedel RF, Larrier N, Dodd L, et al. The clinical management of chondrosarcoma. Curr Treat Options Oncol. 2009;10:94–106.

    Article  PubMed  Google Scholar 

  6. Gelderblom H, Hogendoorn PC, Dijkstra SD, et al. The clinical approach towards chondrosarcoma. Oncologist. 2008;13:320–9.

    Article  PubMed  Google Scholar 

  7. Weber K, Damron TA, Frassica FJ, Sim FH. Malignant bone tumors. Instr Course Lect. 2008;57:673–88.

    PubMed  Google Scholar 

  8. Reliability of histopathologic and radiologic grading of cartilaginous neoplasms in long bones. J Bone Joint Surg Am. 2007;89:2113–23.

  9. Eefting D, Schrage YM, Geirnaerdt MJ, et al. Assessment of interobserver variability and histologic parameters to improve reliability in classification and grading of central cartilaginous tumors. Am J Surg Pathol. 2009;33:50–7.

    Article  PubMed  Google Scholar 

  10. Welkerling H, Kratz S, Ewerbeck V, Delling G. A reproducible and simple grading system for classical chondrosarcomas. Analysis of 35 chondrosarcomas and 16 enchondromas with emphasis on recurrence rate and radiological and clinical data. Virchows Arch. 2003;443:725–33.

    Article  PubMed  Google Scholar 

  11. Deloin X, Dumaine V, Biau D, et al. Pelvic chondrosarcomas: surgical treatment options. Rev Chir Orthop Traumatol. 2009;95:393–401.

    CAS  Google Scholar 

  12. Donati D, El GA, Bertoni F, et al. Surgical treatment and outcome of conventional pelvic chondrosarcoma. J Bone Joint Surg Br. 2005;87:1527–30.

    Article  PubMed  CAS  Google Scholar 

  13. Pring ME, Weber KL, Unni KK, Sim FH. Chondrosarcoma of the pelvis. A review of sixty-four cases. J Bone Joint Surg Am. 2001;83-A:1630–42.

    PubMed  CAS  Google Scholar 

  14. Sheth DS, Yasko AW, Johnson ME, et al. Chondrosarcoma of the pelvis. Prognostic factors for 67 patients treated with definitive surgery. Cancer. 1996;78:745–50.

    Article  PubMed  CAS  Google Scholar 

  15. Schreuder HW, Pruszczynski M, Veth RP, Lemmens JA. Treatment of benign and low-grade malignant intramedullary chondroid tumours with curettage and cryosurgery. Eur J Surg Oncol. 1998;24:120–6.

    Article  PubMed  CAS  Google Scholar 

  16. Mohler DG, Chiu R, McCall DA, Avedian RS. Curettage and cryosurgery for low-grade cartilage tumors is associated with low recurrence and high function. Clin Orthop Relat Res. 2010;468:2765–73.

    Article  PubMed  Google Scholar 

  17. Ahlmann ER, Menendez LR, Fedenko AN, Learch T. Influence of cryosurgery on treatment outcome of low-grade chondrosarcoma. Clin Orthop Relat Res. 2006;451:201–7.

    Article  PubMed  Google Scholar 

  18. Souna BS, Belot N, Duval H, et al. No recurrences in selected patients after curettage with cryotherapy for grade I chondrosarcomas. Clin Orthop Relat Res. 2010;468:1956–62.

    Article  PubMed  Google Scholar 

  19. Leerapun T, Hugate RR, Inwards CY, et al. Surgical management of conventional grade I chondrosarcoma of long bones. Clin Orthop Relat Res. 2007;463:166–72.

    PubMed  Google Scholar 

  20. Etchebehere M, de Camargo OP, Croci AT, et al. Relationship between surgical procedure and outcome for patients with grade I chondrosarcomas. Clinics (Sao Paulo). 2005;60:121–6.

    Google Scholar 

  21. Donati D, Colangeli S, Colangeli M, et al. Surgical treatment of grade I central chondrosarcoma. Clin Orthop Relat Res. 2010;468:581–9.

    Article  PubMed  Google Scholar 

  22. Bauer HC, Brosjo O, Kreicbergs A, Lindholm J. Low risk of recurrence of enchondroma and low-grade chondrosarcoma in extremities. 80 patients followed for 2–25 years. Acta Orthop Scand. 1995;66:283–8.

    Article  PubMed  CAS  Google Scholar 

  23. Aarons C, Potter BK, Adams SC, et al. Extended intralesional treatment versus resection of low-grade chondrosarcomas. Clin Orthop Relat Res. 2009;467:2105–11.

    Article  PubMed  Google Scholar 

  24. Cheng JC, Johnston JO. Giant cell tumor of bone. Prognosis and treatment of pulmonary metastases. Clin Orthop Relat Res. 1997; 338:205–14.

    Google Scholar 

  25. Faisham WI, Zulmi W, Saim AH, Biswal BM. Pulmonary metastases of giant cell tumour of the bone. Med J Malaysia. 2004;59(Suppl F):78–81.

    PubMed  Google Scholar 

  26. Kay RM, Eckardt JJ, Seeger LL, et al. Pulmonary metastasis of benign giant cell tumor of bone. Six histologically confirmed cases, including one of spontaneous regression. Clin Orthop Relat Res. 1994;302:219–30.

    Google Scholar 

  27. Treadwell JR, Tregear SJ, Reston JT, Turkelson CM 2006 A system for rating the stability and strength of medical evidence. BMC Med Res Methodol. 6:52.

    Article  PubMed  Google Scholar 

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The authors declare no conflict of interest.

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Correspondence to Michelle Ghert MD, FRCSC.

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Hickey, M., Farrokhyar, F., Deheshi, B. et al. A Systematic Review and Meta-analysis of Intralesional Versus Wide Resection for Intramedullary Grade I Chondrosarcoma of the Extremities. Ann Surg Oncol 18, 1705–1709 (2011). https://doi.org/10.1245/s10434-010-1532-z

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  • DOI: https://doi.org/10.1245/s10434-010-1532-z

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