| Giant cell tumor of bone: risk factors for recurrence. | |
| | |
MedLine Citation:
|
PMID: 20706812 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Many surgeons treat giant cell tumor of bone (GCT) with intralesional curettage. Wide resection is reserved for extensive bone destruction where joint preservation is impossible or when expendable sites (eg, fibular head) are affected. Adjuvants such as polymethylmethacrylate and phenol have been recommended to reduce the risk of local recurrence after intralesional surgery. However, the best treatment of these tumors and risk factors for recurrence remain controversial. QUESTIONS/PURPOSES: We evaluated the recurrence-free survival after surgical treatment of GCT to determine the influence of the surgical approach, adjuvant treatment, local tumor presentation, and demographic factors on the risk of recurrence. METHODS: We retrospectively reviewed 118 patients treated for benign GCT of bone between 1985 and 2005. Recurrence rates, risk factors for recurrence and the development of pulmonary metastases were determined. The minimum followup was 36 months (mean, 108.4 ± 43.7; range, 36-233 months). RESULTS: Wide resection had a lower recurrence rate than intralesional surgery (5% versus 25%). Application of polymethylmethacrylate decreased the risk of local recurrence after intralesional surgery compared with bone grafting; phenol application alone had no effect on the risk of recurrence. Pulmonary metastases occurred in 4%; multidisciplinary treatment including wedge resection, chemotherapy, and radiotherapy achieved disease-free survival or stable disease in all of these patients. CONCLUSION: We recommend intralesional surgery with polymethylmethacrylate for the majority of primary GCTs. Because pulmonary metastases are rare and aggressive treatment of pulmonary metastases is usually successful, we believe the potential for metastases should not by itself create an indication for wide resection of primary tumors. LEVEL OF EVIDENCE: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. |
| | |
Authors:
|
Frank M Klenke; Doris E Wenger; Carrie Y Inwards; Peter S Rose; Franklin H Sim |
Publication Detail:
|
Type: Journal Article Date: 2010-08-13 |
Journal Detail:
|
Title: Clinical orthopaedics and related research Volume: 469 ISSN: 1528-1132 ISO Abbreviation: Clin. Orthop. Relat. Res. Publication Date: 2011 Feb |
Date Detail:
|
Created Date: 2011-01-11 Completed Date: 2011-02-24 Revised Date: 2013-05-29 |
Medline Journal Info:
|
Nlm Unique ID: 0075674 Medline TA: Clin Orthop Relat Res Country: United States |
Other Details:
|
Languages: eng Pagination: 591-9 Citation Subset: AIM; IM |
Affiliation:
|
Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Antineoplastic Agents / therapeutic use Bone Cements / therapeutic use Bone Neoplasms / drug therapy, mortality, pathology* Chemotherapy, Adjuvant Disease-Free Survival Female Giant Cell Tumor of Bone / drug therapy, mortality, secondary* Humans Lung Neoplasms / drug therapy, mortality, secondary* Male Middle Aged Minnesota / epidemiology Neoplasm Recurrence, Local / diagnosis* Polymethyl Methacrylate / therapeutic use Retrospective Studies Risk Factors Young Adult |
| Chemical | |
Reg. No./Substance:
|
0/Antineoplastic Agents; 0/Bone Cements; 9011-14-7/Polymethyl Methacrylate |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: A second decade lifetable survival analysis of the Oxford unicompartmental knee arthroplasty.
Next Document: The John Insall Award: control-matched evaluation of painful patellar Crepitus after total knee arth...