Treatment strategies for central low-grade chondrosarcoma of long bones: a systematic review of the literature and meta-analysis

S. S. Shemesh, J. D. Acevedo-Nieves, Juan Abelardo Augusto Pretell

Research output: Contribution to journalReview article

6 Citations (Scopus)

Abstract

The need for wide local excision (WLE) versus intralesional (IL) treatment of low-grade chondrosarcomas (CS) of the appendicular skeleton remains controversial. We sought to perform a systematic review and meta-analysis to compare different conventional types of surgical treatments for grade I CS in terms of: (1) rate of local recurrence (LR) and metastases, (2) functional outcome as measured by the Musculoskeletal Tumor Society (MSTS) score, (3) complication rate. Eighteen studies enrolling 695 patients met our criteria. Studies reported on WLE versus IL treatment (n = 7), and IL treatment with or without different adjuvants (N = 11). The LR rate was not significantly different between WLE and IL treatment (OR 2.31; 95% CI, 0.85–6.2; P = 0.1). On the contrary, complication rates were significantly lower in favor of IL treatment (OR 2.27; 95% CI, 0.07–0.72; P = 0.012). The mean reported MSTS score ranged from 21.8 to 28.2 for WLE and from 26.5 to 29.7 for IL treatment, with a significant difference in favor of IL treatment. IL treatment as an alternative to WLE does not greatly increase the risk of LR or metastasis and has lower complication rates with better functional scores. In light of the retrospective nature of the studies available, our findings should be interpreted with caution.

Original languageEnglish (US)
Pages (from-to)95-109
Number of pages15
JournalMusculoskeletal Surgery
Volume102
Issue number2
DOIs
StatePublished - Aug 1 2018

Fingerprint

Chondrosarcoma
Meta-Analysis
Bone and Bones
Therapeutics
Recurrence
Neoplasm Metastasis
Skeleton
Neoplasms
Retrospective Studies

Keywords

  • Adjuvant
  • Intralesional treatment
  • Low-grade chondrosarcoma
  • Recurrence
  • Wide local excision

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Treatment strategies for central low-grade chondrosarcoma of long bones : a systematic review of the literature and meta-analysis. / Shemesh, S. S.; Acevedo-Nieves, J. D.; Pretell, Juan Abelardo Augusto.

In: Musculoskeletal Surgery, Vol. 102, No. 2, 01.08.2018, p. 95-109.

Research output: Contribution to journalReview article

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abstract = "The need for wide local excision (WLE) versus intralesional (IL) treatment of low-grade chondrosarcomas (CS) of the appendicular skeleton remains controversial. We sought to perform a systematic review and meta-analysis to compare different conventional types of surgical treatments for grade I CS in terms of: (1) rate of local recurrence (LR) and metastases, (2) functional outcome as measured by the Musculoskeletal Tumor Society (MSTS) score, (3) complication rate. Eighteen studies enrolling 695 patients met our criteria. Studies reported on WLE versus IL treatment (n = 7), and IL treatment with or without different adjuvants (N = 11). The LR rate was not significantly different between WLE and IL treatment (OR 2.31; 95{\%} CI, 0.85–6.2; P = 0.1). On the contrary, complication rates were significantly lower in favor of IL treatment (OR 2.27; 95{\%} CI, 0.07–0.72; P = 0.012). The mean reported MSTS score ranged from 21.8 to 28.2 for WLE and from 26.5 to 29.7 for IL treatment, with a significant difference in favor of IL treatment. IL treatment as an alternative to WLE does not greatly increase the risk of LR or metastasis and has lower complication rates with better functional scores. In light of the retrospective nature of the studies available, our findings should be interpreted with caution.",
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