title: Surgical treatment of central grade 1 chondrosarcoma of the appendicular skeleton.
abstract: BACKGROUND
  Diagnosis and treatment of low-grade chondrosarcoma remain controversial. We performed a review of a single-center series with the aims of assessing the oncologic outcome of these patients, verifying if intralesional curettage can be adequate treatment, and defining clinical criteria to support the surgeon and the oncologist in decision-making for surgery and subsequent follow-up.
  
  
  METHODS
  A retrospective review of 85 patients was performed (61 females and 24 males, age range 20-76 years). The site of the lesion was the femur in 35 cases, humerus in 33, tibia in 15, and fibula in 2. Sixty-four patients were treated by intralesional curettage. Twenty-one patients with aggressive radiological patterns were treated with wide resection.
  
  
  RESULTS
  Mean follow-up was 67 months (range 24-206 months). Two patients developed local recurrence, both after intralesional curettage. The difference in incidence of recurrence was not statistically significant between the two groups. No distant metastases were observed. Postsurgical complications were significantly higher in the resection group.
  
  
  CONCLUSIONS
  Low-grade chondrosarcoma of the appendicular skeleton without aggressive radiological patterns can be treated with intralesional surgery with good oncological outcome and very low rate of postsurgical complications. Wide resection, following surgical principles of malignant bone tumors, should be considered only when aggressive biologic behavior is evident on imaging.
authors: Department of Orthopaedic Oncology and Reconstructive Surgery, Azienda Ospedaliera Universitaria Careggi, Florence, Italy. campanaccid@gmail.com
authors: Domenico Andrea
authors: DA
authors: Campanacci
authors: Guido
authors: G
authors: Scoccianti
authors: Alessandro
authors: A
authors: Franchi
authors: Giuliana
authors: G
authors: Roselli
authors: Giovanni
authors: G
authors: Beltrami
authors: Massimiliano
authors: M
authors: Ippolito
authors: Giuseppe
authors: G
authors: Caff
authors: Filippo
authors: F
authors: Frenos
authors: Rodolfo
authors: R
authors: Capanna
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000601:surgery*; D002813:Chondrosarcoma / Q000601:surgery*; D003475:Curettage; D005260:Female; D005266:Femoral Neoplasms / Q000601:surgery; D005360:Fibula / Q000601:surgery; D006801:Humans; D006811:Humerus / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult