Treatment of locally aggressive benign bone tumors by means of extended intralesional curettage without chemical adjuvants

Abstract

Objectives: The aim of this study is to present the clinical, oncological, and functional results of locally aggressive benign bone tumors treated with extended intralesional curettage without the use of adjuvant in a tertiary orthopedic oncology center. Method: A total of 172 patients treated with surgical curettage and high-speed burrs for the diagnosis of aneurysmal bone cyst, giant cell tumor, osteoblastoma, chondroblastoma, and chondromyxoid fibroma were included in the study. Demographic, radiological, and clinical data of the patients were analyzed. Results: One-hundred seventy two patients (101 (59%) female and 71 (41%) male) with a mean age of 23 years (6–84). The mean follow-up period was 48 months (18–108). In the study, a total of 8 (4.6%) patients had postoperative complications, 17 (9.9%) patients had recurrence in the postoperative period. Diameter greater than 5 cm was found to be a risk factor for recurrence (p < 0.004). The probability of developing complications was found to be significantly higher in patients with recurrence (p < 0.001). There was no significant relationship between recurrence and age, tumor type, and tumor stage. Conclusion: Successful treatment results can be obtained with extended surgical curettage, high-speed burr, and cauterization without the use of chemical adjuvants in locally aggressive bone tumors.

The effect of adjuvant cryotherapy added to well-performed high-speed burr curettage on the long-term surgical outcomes of chondroblastoma cases

“…As a result, the need for adjuvant treatment arises. High-speed burring (local recurrence rates, 3.2% and 0%, respectively), [31,32] phenol (local recurrence rates, 10% and 9.7%, respectively), [16,33] liquid nitrogen (local recurrence rates, 7.1%, 0%, 7.5%, 7.1%, and 5.5%, respectively), [13][14][15]34] electrocauterization (local recurrence rates, 9.9% and 21.4%, respectively), [9,35] and cementing (local recurrence rate, 4.2%,) [36] have been used as local adjuvants and have been shown to decrease recurrence rates. Local adjuvants can significantly influence the control of local recurrence.…”

“…Curettage has been described as performed alone[ 22 , 23 ] or with adjuvants such as high-speed burring,[ 21 ] cryosurgery,[ 13 ] hydrogen peroxide,[ 24 ] and cauterization. [ 9 ] Defects are filled with bone grafting or polymethacrylate. En-bloc resection[ 21 ] and percutaneous radiofrequency heat ablation (RF)[ 25 ] are the other treatment options for chondroblastoma.…”

“…[ 7 , 8 ] Successful treatment results can be obtained with extended surgical curettage, high-speed burr, and cauterization without using chemical adjuvants in locally aggressive bone tumors. [ 9 ] Filling the cavity formed after curettage with polymethylmethacrylate (PMMA) is another recommended treatment method. [ 8 , 10 ] Aggressive curettage and bone grafting are mostly preferred.…”