OBJECTIVE: To evaluate the efficacy of the Enneking Staging System in determining the prognosis, planning surgical treatment and indicating adjuvant therapy for the treatment of benign bone tumors (BBT) and tumor-like bone lesions (TBL). METHODS: A retrospective multicentric, descriptive, nonrandomized study was carried out comprising a large series of 165 patients with a total of 168 benign bone tumors and pseudotumoral bone lesions. The patient sampling was typical, and matched the literature in all aspects. All the patients were classified according to the Enneking Staging System, and were reevaluated after either conservative or surgical treatment, to establish the efficacy of the system. Treatment options and clinical complications were analyzed. RESULTS: The results of the treatment provided 95.2% agreement with the Enneking Staging System, with a 95% confidence interval of between 90.8 and 97.9%. Of the 168 tumors treated, only eight (4.8%) could not be controlled by the initial treatment indicated by the Enneking Staging System. Tumors classified as active were the most prevalent, comprising 73.2% of the lesions. Tumor recurrence was significantly higher (p<0.001) for the aggressive stage. The study also suggested that wide surgical margins could be more efficient in reducing the recurrence of aggressive lesions (p>0.001). All the patients staged as latent were healed. Bone cement (PMMA) was an effective adjuvant when associated with marginal surgery. For latent and active lesions, the study demonstrated the efficacy of treatments with observation only, or with excision, with or without autogenous bone graft. CONCLUSION: The results confirm that the Enneking Staging System was very efficient in determining prognosis, assisting surgical planning and indicating adjuvant therapy in the treatment of BBT and TBL.
Bone diseases; Bone neoplasms; Bone neoplasms; Bone neoplasms; Bone neoplasms; Bone neoplasms; Neoplasm staging
