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01-08-2018 | Review

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

Authors: S. S. Shemesh, J. D. Acevedo-Nieves, J. Pretell-Mazzini

Published in: MUSCULOSKELETAL SURGERY | Issue 2/2018

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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Title: Treatment strategies for central low-grade chondrosarcoma of long bones: a systematic review of the literature and meta-analysis
Authors: S. S. Shemesh
J. D. Acevedo-Nieves
J. Pretell-Mazzini
Publication date: 01-08-2018
Publisher: Springer Milan
Published in: MUSCULOSKELETAL SURGERY / Issue 2/2018
Print ISSN: 2035-5106
Electronic ISSN: 2035-5114
DOI: https://doi.org/10.1007/s12306-017-0507-7

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

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