S0344 Intralesional Resection in Treating Patients With Chondrosarcoma of the Bone
S0344 Intralesional Resection in Treating Patients With Chondrosarcoma of the Bone
RATIONALE: Intralesional resection is a less invasive type of surgery for chondrosarcoma of
 the bone and may have fewer side effects and improve recovery.

 PURPOSE: This phase II trial is studying how well intralesional resection works in treating
 patients with low-grade chondrosarcoma of the bone.
OBJECTIVES:

 -  Determine the probability of local complications (e.g., fracture, nerve palsy, deep
 venous thrombosis, unexpected rehospitalization, unanticipated reoperation, or death
 within 2 years) in patients with suspected low-grade intracompartmental chondrosarcoma
 of the bone undergoing intralesional resection.

 -  Determine the 5-year probability of local recurrence and development of metastatic
 disease in patients undergoing this procedure.

 -  Determine the impact of musculoskeletal tumor reconstruction on the functional status of
 patients undergoing this procedure.

 OUTLINE: This is a multicenter study.

 Patients undergo intralesional resection (curettage with high-speed burr). Patients then
 receive local adjuvant treatment comprising liquid nitrogen, phenol, alcohol, or argon beam
 to the excision site. The bone cavity is then filled with either polymethyacrylate cement or
 a bone graft (allograft or homograft). Patients may also have a metal plate installed at the
 wound site.

 Patients are followed every 3 months for 1 year and then every 6 months for 4 years.

 PROJECTED ACCRUAL: A total of 60 patients will be accrued for this study within 30-60 months.
DISEASE CHARACTERISTICS:

 -  Suspected low-grade intracompartmental chondrosarcoma, as defined by the following
 criteria:

 -  Resorption of prior calcifications (indicated by a change in radiographic
 appearance over time) AND/OR meets at least 2, but no more than 4, of the
 following criteria:

 -  Permeative appearance of medullary bone, defined as presence of tumor around
 3 sides of a trabecula of normal bone

 -  Endosteal scalloping, defined as > 50% of adjacent cortical thickness

 -  Cortical thickening beyond the thickness of adjacent normal bone

 -  Bone expansion, defined as a circumferential increase in diameter of the
 bone beyond the adjacent normal bone

 -  Positive (i.e., increased uptake or "hot") bone scan

 -  No cortical disruption and/or soft tissue mass by radiography and CT scan (3 mm cuts
 are optimal) or MRI

 -  No presumptive axial (spinal) involvement

 -  No multifocal disease by bone scan

 PATIENT CHARACTERISTICS:

 Age

 -  18 and over

 Performance status

 -  Not specified

 Life expectancy

 -  Not specified

 Hematopoietic

 -  Not specified

 Hepatic

 -  Not specified

 Renal

 -  Not specified

 Other

 -  No other malignancy within the past 5 years except adequately treated basal cell or
 squamous cell skin cancer, carcinoma in situ of the cervix, or adequately treated
 stage I or II cancer in complete remission

 PRIOR CONCURRENT THERAPY:

 Biologic therapy

 -  No prior biologic therapy for this tumor

 Chemotherapy

 -  No prior chemotherapy for this tumor

 Endocrine therapy

 -  Not specified

 Radiotherapy

 -  No prior radiotherapy for this tumor

 Surgery

 -  No prior surgery for this tumor except biopsy*

 -  No concurrent intramedullary fixation NOTE: *Biopsy is not required

 Other

 -  No prior investigational anticancer agents for this tumor