Low-Grade Chondrosarcoma of Long Bones Treated with Intralesional Curettage Followed by Application of Phenol, Ethanol, and Bone-Grafting

作者：Verdegaal Suzan H M^*; Brouwers Hugo F G; van Zwet Erik W; Hogendoorn Pancras C W; Taminiau Antonie H M

来源：Journal of Bone and Joint Surgery-American Volume, 2012, 94A(13): 1201-1207.

DOI：10.2106/JBJS.J.01498

Background: A common treatment of low-grade cartilaginous lesions of bone is intralesional curettage with local adjuvant therapy. Because of the wide variety of different diagnoses and treatments, there is still a lack of knowledge about the effectiveness of the use of phenol as local adjuvant therapy in patients with graded central chondrosarcoma of a long bone. %26lt;br%26gt;Methods: A retrospective study was done to assess the clinical and oncological outcomes after intralesional curettage, application of phenol and ethanol, and bone-grafting in eighty-five patients treated between 1994 and 2005. Inclusion criteria were histologically proven graded central chondrosarcoma and location of the lesion in a long bone. The average age at surgery was 47.5 years (range, 15.6 to 72.3 years). The average duration of follow-up was 6.8 years (range, 0.2 to 14.1 years). Patients were evaluated periodically with conventional radiographs and gadolinium-enhanced magnetic resonance imaging (Gd-MRI) scans. When a lesion was suspected on the basis of the MRI, the patient underwent repeat intervention. Depending on the size of the recurrent lesion, biopsy followed by radiofrequency ablation (for lesions of %26lt;10 mm) or repeat curettage (for those of mm) was performed. %26lt;br%26gt;Results: Of the eighty-five patients, eleven underwent repeat surgery because a lesion was suspected on the basis of the Gd-MRI studies during follow-up. Of these eleven, five had a histologically proven local recurrence (a recurrence rate of 5.9% [95% confidence interval, 0.9% to 10.9%]), and all were graded chondrosarcomas. General complications consisted of one superficial infection, and two femoral fractures within six weeks after surgery. %26lt;br%26gt;Conclusions: This retrospective case series without controls has limitations, but the use of phenol as an adjuvant after intralesional curettage of low-grade chondrosarcoma of a long bone was safe and effective, with a recurrence rate of %26lt;6% at a mean of 6.8 years after treatment.

• 出版日期2012-7-3