title: Fifteen years of bone tumor cryosurgery: a single-center experience of 440 procedures and long-term follow-up.
abstract: BACKGROUND
  This summary of a single center's extensive cumulative experience in bone tumor cryosurgery assesses the long-term outcome of bone conservation surgery in which adjuvant cryosurgery plays a pivotal role.
  
  
  METHODS
  We performed 440 cryosurgical procedures between January 1988 and December 2002. Two-thirds of the series comprised a variety of primary benign-aggressive and low-grade malignant lesions, and one-third were primary high-grade and metastatic bone tumors. The anatomical locations included almost every bone of the skeleton. Two methods of bone cryosurgery were used: Marcove's "open" direct-pour system using liquid nitrogen (1988-1997) and Meller's "closed" argon-based system (1998 to the present).
  
  
  RESULTS
  The study cohort consisted of 214 males and 191 females (age range 5-82 years). The median follow-up was 7 years (range 3-18). The overall local recurrence rate was 8%: fractures=1%, infections=2% and skin burns=1.3%. There were three cases of transient nerve palsies in areas other than the sacrum, and four cases of late osteoarthritis of an adjacent joint. The functional outcome for the 372 patients with no evidence of disease was almost 100% "good" and "excellent" (American Musculo-skeletal Tumor Society System). Only two patients needed secondary amputations.
  
  
  CONCLUSIONS
  Bone cryosurgery is a safe and effective limb-, joint- and even epiphysis-sparing surgical technique in suitable types of bone tumors, temporarily or permanently obviating the need for resection surgery.
authors.affiliation: The National Unit of Orthopedic Oncology, Tel-Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizman Street, Tel-Aviv 64329, Israel. Electronic address: imortonc@tasmc.health.gov.il.
authors.forename: I
authors.initials: I
authors.lastname: Meller
authors.affiliation: The National Unit of Orthopedic Oncology, Tel-Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizman Street, Tel-Aviv 64329, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Weinbroum
authors.affiliation: The National Unit of Orthopedic Oncology, Tel-Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizman Street, Tel-Aviv 64329, Israel.
authors.forename: J
authors.initials: J
authors.lastname: Bickels
authors.affiliation: The National Unit of Orthopedic Oncology, Tel-Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizman Street, Tel-Aviv 64329, Israel.
authors.forename: S
authors.initials: S
authors.lastname: Dadia
authors.affiliation: The National Unit of Orthopedic Oncology, Tel-Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizman Street, Tel-Aviv 64329, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Nirkin
authors.affiliation: The National Unit of Orthopedic Oncology, Tel-Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizman Street, Tel-Aviv 64329, Israel.
authors.forename: O
authors.initials: O
authors.lastname: Merimsky
authors.affiliation: The National Unit of Orthopedic Oncology, Tel-Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizman Street, Tel-Aviv 64329, Israel.
authors.forename: J
authors.initials: J
authors.lastname: Issakov
authors.affiliation: The National Unit of Orthopedic Oncology, Tel-Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizman Street, Tel-Aviv 64329, Israel.
authors.forename: G
authors.initials: G
authors.lastname: Flusser
authors.affiliation: The National Unit of Orthopedic Oncology, Tel-Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizman Street, Tel-Aviv 64329, Israel.
authors.forename: N
authors.initials: N
authors.lastname: Marouani
authors.affiliation: The National Unit of Orthopedic Oncology, Tel-Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizman Street, Tel-Aviv 64329, Israel.
authors.forename: N
authors.initials: N
authors.lastname: Cohen
authors.affiliation: The National Unit of Orthopedic Oncology, Tel-Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizman Street, Tel-Aviv 64329, Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Kollender
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003452:Cryosurgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome