Oncologic Impact of the Curettage of Grade 2 Central Chondrosarcoma of the Extremity

Background. Wide excision is considered the standard treatment for high-grade chondrosarcoma, but little is known regarding the effect of curettage on patient outcome in grade 2 chondrosarcoma. Methods. The records of 32 patients with nonmetastatic grade 2 central chondrosarcoma of the appendicular skeleton were analyzed. The clinical characteristics and outcomes of 15 patients who underwent curettage (the case group) followed by subsequent treatment and 17 patients who underwent standard treatment were compared. The mean follow-up period for all 32 patients was 110 months (range, 31-230 months). Results. Cases had a smaller tumor volume at presentation (P = .02), a lower Enneking's stage IIA (P < .01), a lower rate of biopsy (P < .01), and a lower incidence of chondroid calcification by plain radiography (P < .01) than controls. Of the 32 study subjects, 2 (1 in the each group) developed local recurrence. The 10-year overall and metastasis-free survival rates for all 32 chondrosarcomas were 84.6% +/- A 14.5% and 70.3% +/- A 16.5%, respectively. Event-free survivals were similar for cases and controls (P = .16). Conclusions. Intracompartmental grade 2 chondrosarcoma with nonaggressive radiologic pattern have a chance of curettage. However, proper subsequent management achieves outcomes comparable with those of primary wide excision.