The need for segmental resection versus intralesional treatment of low-grade chondrosarcomas of the appendicular skeleton
remains controversial. We hypothesized extended intralesional treatment would equally control malignant disease but with improved
functional outcomes and decreased postoperative complications. We retrospectively reviewed 31 patients with 32 Grade I intracompartmental
chondrosarcomas of the long bones of the appendicular skeleton treated with either resection (15 lesions) or extended intralesional
curetting (17) at a minimum followup of 2 years (median, 55 months; range, 24–203 months). Lesions were larger and median
followup was longer in the resection cohort. One local recurrence developed in each treatment cohort and neither transitioned
to a higher grade of tumor. No patient had metastases develop or died of disease. The mean final Musculoskeletal Tumor Society
functional scores were greater after extended intralesional versus resection treatment (29.5 versus 25.1). Complications were
observed more frequently after resection and reconstruction (seven of 15) as compared with extended intralesional treatment
(one of 17). Extended intralesional treatment of Grade I intracompartmental chondrosarcomas of the long bones of the appendicular
skeleton therefore appears safe with improved functional scores and decreased complications versus segmental resection and
reconstruction.
Level of Evidence: Level III, therapeutic study. See the 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.