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
Department of Orthopaedic Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands.
J Surg Oncol. 2008 Nov 1;98(6):421-6. doi: 10.1002/jso.21122.
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.
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).
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%).
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.
使用液氮的冷冻手术作为骨肿瘤病灶内切除术后的辅助治疗手段，用于诱导细胞死亡。其目的是扩大手术切缘并降低局部复发率。本研究旨在分析其肿瘤学及功能学结果。
我们研究了123例患者的130个肿瘤行刮除术及冷冻手术的肿瘤学及功能学结果。其中有75例内生软骨瘤和55例1级软骨肉瘤。所有患者的最短随访期为2年（范围24 - 119个月）。
随访期间，1例活跃性内生软骨瘤和1例侵袭性内生软骨瘤出现局部复发。再次行刮除术及冷冻手术治疗。两名患者在至少3年的随访期内均无疾病复发。未观察到1级软骨肉瘤治疗后出现局部复发。根据MSTS评分系统，功能评分在随访2年时平均为28分（94%）。18例患者（14%）出现术后骨折。
内生软骨瘤和1级软骨肉瘤的刮除术及冷冻手术具有良好的肿瘤学及功能学结果。已调整术后管理以减少骨折数量。
