Grade I chondrosarcoma of bone: the Münster experience

The surgical treatment of low-grade chondrosarcoma is controversial and the clinical course is difficult to predict. The purpose of this retrospective study was to review the authors' experience with the surgical treatment of 80 patients with grade I chondrosarcoma. Intralesional resection margins increased the rate of local recurrence statistically significant (p < 0.001). However, there was no influence of the resection margins on the overall survival (p > 0.05) or on the rate of metastasis (p > 0.05). Conservative surgery for special indications with adjuvant use of PMMA (poly-methylmethacrylate) offers satisfying local tumour control rates in the long bones. However, after intralesional tumour resection of pelvic chondrosarcoma, four out of four patients developed a local recurrence, whereas no patient treated with wide resection margins received a local relapse, which has been statistically significant (p < 0.001). In conclusion, intralesional resection of a grade I chondrosarcoma has a higher overall risk of local recurrence but is not associated with a poorer survival. This procedure can be recommended for stage I A tumours of the long bones of the extremities. However, in pelvic lesions it should be avoided because of a 100% recurrence rate.