The grade of chondrosarcoma relates to the likelihood of local recurrence and metastases. Many Grade I chondrosarcomas behave
benignly if aggressively, and the question arises regarding whether wide resection is essential to control the disease. We
therefore asked whether intralesional surgery also could be extended to Grade I chondrosarcomas without an increase in recurrence.
We retrospectively reviewed 31 patients with Grade I chondrosarcomas of the limbs. The minimum followup was 66 months (mean,
157 months; range, 66–296 months). None of the 16 patients treated by resection had recurrences during the followup and two
of the 15 patients with intralesional excision had recurrences, both of which resolved with resection of the site involved
by the recurrence without progression of the disease. The Musculoskeletal Tumor Society scores averaged 72% in patients treated
with wide resection compared with 89% in the 15 patients treated by intralesional surgery. The two recurrences occurred in
patients whose radiographs showed thinning of the cortex combined with bone enlargement and marked endosteal scalloping; histologic
examination in these two patients also showed a correlation between radiographic aggressiveness and the presence of myxoid
areas and hypercellularity.
Level of Evidence: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
Each author certifies that he or she has no commercial associations (eg, consultancies, stock, ownership, equity interest,
patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations
were conducted in conformity with ethical principles of research.