Document Detail


Serial arterial embolization for large sacral giant-cell tumors: mid- to long-term results.
MedLine Citation:
PMID:  17471094     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: Level III retrospective case series with historical controls. OBJECTIVE: To evaluate the mid- to long-term outcomes of serial arterial embolization as a primary treatment modality for large sacral giant-cell tumors (SGCT). SUMMARY OF BACKGROUND DATA: Giant-cell tumors are potentially aggressive benign tumors that can cause significant morbidity and may occasionally prove lethal. Large GCTs in the sacrum present a significant challenge, and treatment methods, including surgical resection and radiation, are associated with morbid complications and high recurrence rates. This report presents the mid- to long-term follow-up results of our cases of SGCT treated with serial arterial embolization. METHODS: Nine consecutive patients with biopsy-proven SGCTs received initial primary treatment with serial arterial embolization between 1984 and 2006. All patients underwent angiography and selective arterial embolization at the time of diagnosis, followed by repeat embolization every 6 weeks until no new vessels were noted, and then at 6 and 18 months following stabilization of the lesion. Patients were closely monitored with MRI and/or CT every 6 months for 5 years and annually thereafter. Functional outcomes were measured using the 1993 Musculoskeletal Tumor Society Rating Scale (MSTS93). RESULTS: The mean duration of follow-up in this series was 8.96 years (median, 7.8 years; range, 3.8-21.2 years). No progression was noted in 7 of the 9 cases. Two cases experienced tumor progression of less than 1 cm early in the treatment course and continued to remain asymptomatic. Adjuvant radiation therapy provided local control in 1 of these cases, while radiation and chemotherapy failed in the other case with ultimate mortality. All patients demonstrated substantial pain relief. Cross-sectional MSTS93 scores were obtained in the 8 surviving patients at their most recent follow-up visit with a mean score of 29/30. CONCLUSIONS: Serial arterial embolization is a useful primary treatment modality for large SGCTs given the favorable long-term results and potential morbidity of alternative treatments.
Authors:
Harish S Hosalkar; Kristofer J Jones; Joseph J King; Richard D Lackman
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Spine     Volume:  32     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-05-01     Completed Date:  2007-05-23     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1107-15     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA 19106, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Angiography
Embolization, Therapeutic*
Female
Femoral Artery
Giant Cell Tumors / blood supply,  radiography,  therapy*
Humans
Male
Middle Aged
Retrospective Studies
Sacrum / radiography
Spinal Neoplasms / blood supply,  radiography,  therapy*
Tomography, X-Ray Computed
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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