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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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Related in: MedlinePlus

Kaplan–Meier life table analysis of cumulative event free survival survival of GCT patients according to different local treatment (p = 0.0264).
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Fig3: Kaplan–Meier life table analysis of cumulative event free survival survival of GCT patients according to different local treatment (p = 0.0264).

Mentions: Univariate analyses, as shown in Table 1, were first performed for all 65 patients. Sex, age, tumor site, tumor volume, and pathological grade were not significant. The rate of 3-year EFS was significantly lower for local treatment with bone grafting compared to cement (64.7% vs. 87%, P = 0.038). In contrast to other studies, proximal femur cases had the best prognosis (100%, 3-year EFS), and the distal femur location had the worst (71.4%, 3-year EFS). Even more interestingly, patients with a tumor volume less than 50 ml had a worse 3-year EFS (71.0%) than those with larger tumors (79.4%); this difference was not significant (P = 0.433). Although patients with Jaffe pathological grade I had a higher 3-year EFS than those of grade II, this difference was not significant (P = 0.089). The Kaplan–Meier and log-rank life table analyses also confirmed that local treatment with cement was significantly associated with a higher probability of better events and a better outcome (Figure 3).Table 1


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)

Kaplan–Meier life table analysis of cumulative event free survival survival of GCT patients according to different local treatment (p = 0.0264).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig3: Kaplan–Meier life table analysis of cumulative event free survival survival of GCT patients according to different local treatment (p = 0.0264).
Mentions: Univariate analyses, as shown in Table 1, were first performed for all 65 patients. Sex, age, tumor site, tumor volume, and pathological grade were not significant. The rate of 3-year EFS was significantly lower for local treatment with bone grafting compared to cement (64.7% vs. 87%, P = 0.038). In contrast to other studies, proximal femur cases had the best prognosis (100%, 3-year EFS), and the distal femur location had the worst (71.4%, 3-year EFS). Even more interestingly, patients with a tumor volume less than 50 ml had a worse 3-year EFS (71.0%) than those with larger tumors (79.4%); this difference was not significant (P = 0.433). Although patients with Jaffe pathological grade I had a higher 3-year EFS than those of grade II, this difference was not significant (P = 0.089). The Kaplan–Meier and log-rank life table analyses also confirmed that local treatment with cement was significantly associated with a higher probability of better events and a better outcome (Figure 3).Table 1

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