A systematic review and meta-analysis of intralesional versus wide resection for intramedullary grade I XXXX of the extremities.

@entity1 @entity79 @entity511 @entity3
BACKGROUND: The surgical management of grade I intramedullary @entity79 remains controversial. The purpose of this study was to perform a systematic review and meta-analysis of published data to determine the oncologic outcomes of intralesional versus wide resection for grade I intramedullary @entity511 . METHODS: Literature searches were performed through Medline, EMBASE, and the Cochrane Database. Cohort studies in which one @entity1 group with grade I @entity511 underwent wide resection and one underwent intralesional curettage were included. Two reviewers independently assessed all eligible papers with the Newcastle-Ottawa Quality Assessment Scale for Cohort Studies. The outcome measures were the pooled odds ratio and 95% confidence intervals for the risk of local recurrence and @entity3 calculated through the random-effects method. RESULTS: Five eligible studies were identified including a total of 190 @entity1 , 78 of whom underwent intralesional resection and 112 of whom underwent wide resection. Only one pelvic lesion was identified, which underwent wide resection. There were a total of five local recurrences and three @entity3 . The risk for local recurrence and @entity3 did not differ significantly between the two groups, with an odds ratio for intralesional resection of 2.26 (95% confidence interval, 0.41-12.62) and 0.44 (95% confidence interval, 0.04-5.21) respectively. CONCLUSIONS: Intralesional curettage as an alternative to wide resection for extrapelvic grade I @entity79 does not greatly increase the risk for local recurrence or @entity3 . Overall effect estimates, however, should be interpreted with caution as a result of the relatively small number of events.
