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Local control of giant cell tumors of the long bone after aggressive curettage with and without bone cement.

Gao ZH, Yin JQ, Xie XB, Zou CY, Huang G, Wang J, Shen JN - BMC Musculoskelet Disord (2014)

Bottom Line: The recurrence rates and functional scores associated with the different fillings were analyzed.The Musculoskeletal Tumor Society (MSTS) score for bone graft patients was 91.1%, which was significantly lower than that for patients treated with bone cement (94.7%).Better MSTS functional results were also observed in the bone cement group compared to the bone graft group.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, First Affiliated Hospital of Sun Yat-Sen University, 58# zhongshan 2 road, Guangzhou 510080, P,R, China. shenjingnan@126.com.

ABSTRACT

Background: Aggressive curettage has been well established for the treatment of giant cell tumors (GCTs) of the bone. The purpose of this study was to review our experience and evaluate the role of different implant materials in patients with GCTs of the extremities after aggressive curettage.

Methods: A total of 119 patients with GCTs of the long bone were treated at the First Affiliated Hospital of Sun Yat-Sen University between 2004 and 2009. We excluded patients presenting metastases, recurrent tumors, and soft tissue involvement and those with Jaffe pathological grade III. The remaining 65 patients were treated with aggressive curettage using a bone graft or bone cement to fill the cavity. The recurrence rates and functional scores associated with the different fillings were analyzed.

Results: Aggressive curettage and bone grafting was performed in 34 cases (52.3%), and aggressive curettage with bone cement was performed in 31 cases (47.7%). The overall recurrence rate after the aggressive intralesional procedures was 35.3% with bone grafting and 12.9% when bone cement was used as an adjuvant filling. The recurrence rate following aggressive curettage and bone grafting was higher than that following aggressive curettage with cement (p = 0.038). The Musculoskeletal Tumor Society (MSTS) score for bone graft patients was 91.1%, which was significantly lower than that for patients treated with bone cement (94.7%).

Conclusions: The use of bone cement was associated with a significantly lower recurrence rate than bone grafting following aggressive intralesional curettage to treat benign giant cell tumors of the long bone. Better MSTS functional results were also observed in the bone cement group compared to the bone graft group.

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The interval between surgery and local recurrence for the 16 recurrene patients treated at our hospital.
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Fig2: The interval between surgery and local recurrence for the 16 recurrene patients treated at our hospital.

Mentions: Of the 65 patients in our study, 33 were male and 32 were female, with a mean age of 31.8 years (range: 18–65 years). The tumor site was the proximal femur in 4 cases, the distal femur in 28 cases, the proximal tibia in 27 cases, the distal radius in 5 cases, and the distal tibia in 1 case. The tumor volume ranged from 4 to 310 ml, with an average of 68 ml. The Jaffe pathological grades of the tumors were as follows: I, 14 cases; II, 51 cases. The mean follow-up time was 38.8 months, ranging from 6 to 84 months. At the scheduled follow-up visits, 49 patients (75.4%) had no evidence of disease, and 16 (24.6%) demonstrated local recurrence. The interval between surgery and local recurrence for the 16 patients treated at our hospital ranged from 6 months to 5 years (average, 19.8 months) postoperatively. Thirteen patients (81.3%) had a local recurrence within 2 years after surgery (Figure 2). Only 3 patients (18.7%) had a recurrence after more than 2 years.Figure 2


Local control of giant cell tumors of the long bone after aggressive curettage with and without bone cement.

Gao ZH, Yin JQ, Xie XB, Zou CY, Huang G, Wang J, Shen JN - BMC Musculoskelet Disord (2014)

The interval between surgery and local recurrence for the 16 recurrene patients treated at our hospital.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4196200&req=5

Fig2: The interval between surgery and local recurrence for the 16 recurrene patients treated at our hospital.
Mentions: Of the 65 patients in our study, 33 were male and 32 were female, with a mean age of 31.8 years (range: 18–65 years). The tumor site was the proximal femur in 4 cases, the distal femur in 28 cases, the proximal tibia in 27 cases, the distal radius in 5 cases, and the distal tibia in 1 case. The tumor volume ranged from 4 to 310 ml, with an average of 68 ml. The Jaffe pathological grades of the tumors were as follows: I, 14 cases; II, 51 cases. The mean follow-up time was 38.8 months, ranging from 6 to 84 months. At the scheduled follow-up visits, 49 patients (75.4%) had no evidence of disease, and 16 (24.6%) demonstrated local recurrence. The interval between surgery and local recurrence for the 16 patients treated at our hospital ranged from 6 months to 5 years (average, 19.8 months) postoperatively. Thirteen patients (81.3%) had a local recurrence within 2 years after surgery (Figure 2). Only 3 patients (18.7%) had a recurrence after more than 2 years.Figure 2

Bottom Line: The recurrence rates and functional scores associated with the different fillings were analyzed.The Musculoskeletal Tumor Society (MSTS) score for bone graft patients was 91.1%, which was significantly lower than that for patients treated with bone cement (94.7%).Better MSTS functional results were also observed in the bone cement group compared to the bone graft group.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, First Affiliated Hospital of Sun Yat-Sen University, 58# zhongshan 2 road, Guangzhou 510080, P,R, China. shenjingnan@126.com.

ABSTRACT

Background: Aggressive curettage has been well established for the treatment of giant cell tumors (GCTs) of the bone. The purpose of this study was to review our experience and evaluate the role of different implant materials in patients with GCTs of the extremities after aggressive curettage.

Methods: A total of 119 patients with GCTs of the long bone were treated at the First Affiliated Hospital of Sun Yat-Sen University between 2004 and 2009. We excluded patients presenting metastases, recurrent tumors, and soft tissue involvement and those with Jaffe pathological grade III. The remaining 65 patients were treated with aggressive curettage using a bone graft or bone cement to fill the cavity. The recurrence rates and functional scores associated with the different fillings were analyzed.

Results: Aggressive curettage and bone grafting was performed in 34 cases (52.3%), and aggressive curettage with bone cement was performed in 31 cases (47.7%). The overall recurrence rate after the aggressive intralesional procedures was 35.3% with bone grafting and 12.9% when bone cement was used as an adjuvant filling. The recurrence rate following aggressive curettage and bone grafting was higher than that following aggressive curettage with cement (p = 0.038). The Musculoskeletal Tumor Society (MSTS) score for bone graft patients was 91.1%, which was significantly lower than that for patients treated with bone cement (94.7%).

Conclusions: The use of bone cement was associated with a significantly lower recurrence rate than bone grafting following aggressive intralesional curettage to treat benign giant cell tumors of the long bone. Better MSTS functional results were also observed in the bone cement group compared to the bone graft group.

Show MeSH
Related in: MedlinePlus