Department of Orthopedics, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.
J Surg Oncol. 2021 May;123(8):1821-1827. doi: 10.1002/jso.26457. Epub 2021 Mar 13.
Intralesional surgical treatment is the preferred therapy for atypical cartilaginous tumors (ACTs) of the long bones in many institutions. However, the literature is still controversial regarding intralesional treatment versus wide resection. Due to the relative rarity of these tumors, studies reporting on the results of intralesional treatment are often small sample studies.
We retrospectively analyzed the oncological results of 55 enchondromas, 119 ACTs, and 5 chondrosarcomas grade 2 (CS2) treated with curettage and cryosurgery between the years 2004 and 2017 at our institution. The median follow-up period was 53 months (range, 24-169 months).
In total, seven cases (three ACT, four CS2) recurred. Residual tumor was detected in 20 cases. Three cases underwent secondary curettage and cryosurgery due to local recurrence. Four cases underwent wide resection and reconstruction due to local recurrence with aggressive imaging characteristics. In total, 20 postoperative complications were seen.
Curettage and cryosurgery for enchondroma and ACT show very good oncological results with a low recurrence rate and acceptable complication rate. Curettage and cryosurgery is reliable as a surgical treatment for enchondroma and ACT. Further research should define the criteria for determining which specific cartilaginous tumors necessitate surgical treatment.
在许多机构中，病灶内手术治疗是长骨非典型软骨肿瘤（ACT）的首选治疗方法。然而，对于病灶内治疗与广泛切除的选择，文献仍存在争议。由于这些肿瘤相对罕见，报道病灶内治疗结果的研究往往是小样本研究。
我们回顾性分析了 2004 年至 2017 年间在我院接受刮除和冷冻治疗的 55 例软骨瘤、119 例 ACT 和 5 例 2 级软骨肉瘤（CS2）患者的肿瘤学结果。中位随访时间为 53 个月（范围 24-169 个月）。
共有 7 例（3 例 ACT，4 例 CS2）复发。20 例检测到残留肿瘤。3 例因局部复发行二次刮除和冷冻治疗。4 例因局部复发且影像学特征侵袭性行广泛切除和重建。共发生 20 例术后并发症。
刮除和冷冻治疗软骨瘤和 ACT 的肿瘤学结果非常好，复发率低，并发症发生率可接受。刮除和冷冻治疗是软骨瘤和 ACT 的可靠手术治疗方法。进一步的研究应确定需要手术治疗的特定软骨肿瘤的标准。
