Atypical cartilaginous tumours are usually treated by
curettage. The purpose of this study was to show that
radiofrequency ablation was an effective alternative treatment. We enrolled 20 patients (two male, 18 female, mean age 56 years (36 to 72) in a proof-of-principle study. After inclusion, biopsy and
radiofrequency ablation were performed, followed three months later by
curettage and adjuvant phenolisation. The primary endpoint was the proportional
necrosis in the retrieved material. Secondary endpoints were correlation with the findings on
gadolinium enhanced MRI, functional outcome and complications. Our results show that 95% to 100%
necrosis was obtained in 14 of the 20 patients. MRI had
a 91% sensitivity and 67% specificity for detecting
residual tumour after
curettage. The mean functional outcome (MSTS) score six weeks after
radiofrequency ablation was 27.1 (23 to 30) compared with 18.1 (12 to 25) after
curettage (p < 0.001). No complications occurred after ablation, while two patients developed a
pathological fracture after
curettage. We have shown that
radiofrequency ablation is capable of completely eradicating cartilaginous tumour cells in selective cases. MRI has
a 91% sensitivity for detecting any
residual tumour.
Radiofrequency ablation can be performed on an outpatient basis allowing a rapid return to normal activities. If it can be made more effective, it has the potential to provide better local control, while improving functional outcome.