Low grade central osteosarcoma treated by wide resection-experience in 13 consecutive patients from one center

[Objective]To retrospectively study all the low grade central osteosarcoma(LGCO) cases treated in our center in about a past decade.[Method]Thirteen cases with LGCO treated from January 1998 to June 2008 were studied.The mean age at diagnosis was 31-year-old.The anatomical location of the lesions was similar to that of a conventional osteosarcoma.Pain and mass were common complaints with a mean duration of 16 months before diagnosis.Eight cases accepted the first operation in our center,while the other 5 cases had undergone operations in other hospitals with an intralesional resection in four and a marginal resection in one.Eleven patients had an Enneking stage I disease and two had a stage III disease.The first choice for patients with stage I disease was wide resection.[Result]In two patients with local recurrence,the postoperative pathological diagnoses were fibrosarcoma and malignant fibrous histocytoma respectively.The metastatic lesions were found to be a LGCO in both patients with stage III disease.The average follow up duration was 29 months.Lung metastasis occurred in one stage I patient 15 months after operation.Gama-knife was used to get rid of the lung lesions and then systemic chemotherapy was given.Now he was still alive with disease 27 months after the first operation.One of the 2 patients with stage III disease died of the disease 26 months after operation and the other one was failed to follow up 6 months after operation.The other 10 patients were alive without disease at the last follow-up.For those who received limb salvage operations,the mean MSTS 93 score was 79%.[Conclusion]For most patients with LGCO,wide resection of tumor is preferred.Good oncologic and functional results could be expected after a limb salvage operation without chemotherapy.Insufficient resection of tumor would lead to recurrence.Long time follow up is compulsory.High grade sarcomas would be found in some of the local recurrent lesions.Metastasis would occur in few patients and the metastatic lesions may still be a LGCO.