Can low-grade chondrosarcoma in flat bones be treated with intralesional curettage and cryotherapy?

J Surg Oncol. 2023 Mar;127(3):473-479. doi: 10.1002/jso.27123. Epub 2022 Oct 17.

Abstract

Background and objectives: Chondrosarcomas in flat bones are thought to be more aggressive in their behavior, and little is known about intralesional treatment outcomes of low-grade chondrosarcoma in these locations. We tried to find the differences between patients who had low-grade chondrosarcoma in their flat bones versus those with long bone involvement with regard to (1) disease outcome, (2) functional outcome, and (3) treatment complications.

Methods: We retrospectively reviewed 44 patients with primary low-grade chondrosarcoma who were treated with intralesional curettage and cryotherapy. The patients were divided by location of tumor, group I (flat bones, seven patients) and group II (long bones, 37 patients).

Results: The local recurrence rate was higher in group I with 5 years disease-free survival of 80.0% in group I and 97.0% in group II (p = 0.001). All recurrent cases were noted to have initially presented with soft tissue extension (Enneking stage IB). The mean Musculoskeletal Tumor Society score at the last follow-up was 21.7 in group I and 27.9 in group II (p = 0.045).

Conclusions: Intralesional curettage and cryotherapy for low-grade chondrosarcoma appear to be a safe and reasonable surgical option for patients with lesions confined to bone (Enneking stage IA).

Level of evidence: Level III, retrospective cohort study. See the Guidelines for Authors for a complete description of levels of evidence.

Keywords: atypical cartilaginous tumor; chondrosarcoma; cryotherapy; low-grade chondrosarcoma.

MeSH terms

  • Bone Neoplasms* / surgery
  • Chondrosarcoma* / surgery
  • Cryotherapy
  • Curettage / adverse effects
  • Humans
  • Neoplasm Recurrence, Local / surgery
  • Retrospective Studies
  • Treatment Outcome