The cases of twenty-five patients with Stage-I parosteal osteosarcoma
were analyzed to ascertain the incidence of recurrence after forty-two
various surgical procedures that produced an intracapsular, marginal, wide,
or radical excisional margin. Ten intracapsular resections were followed by
local recurrence in each patient. This procedure usually was done to
shell-out a presumably benign lesion. Marginal excision was successful in
nine of seventeen patients. When a marginal excision was knowingly done to
preserve a major neurovascular bundle, the risk of recurrence was less
(three of eleven) than when it was done to shell-out a presumptively benign
lesion (five of six). The fourteen procedures that achieved wide margins
obtained local control--that is, there was no recurrence--in each patient.
There was one radical procedure without recurrence.