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Surgery methods and soft tissue extension are the potential risk factors of local recurrence in giant cell tumor of bone.

Li D, Zhang J, Li Y, Xia J, Yang Y, Ren M, Liao Y, Yu S, Li X, Shen Y, Zhang Y, Yang Z - World J Surg Oncol (2016)

Bottom Line: A total of 179 patients treated for GCTB between 1998 and 2010 were concluded in the retrospective study.The higher risk of local recurrence was found for soft tissue extension (hazard = 7.921, 95% CI 1.107~56.671), compared with no statistical significances between gender, location, Campanacci grade, pathologic fracture, and local recurrences, which were shown by Kaplan-Meier analysis.However, recurrence-free survival (RFS) of patients younger than 30 was significantly lower than that of patients older than 30.

View Article: PubMed Central - PubMed

Affiliation: Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Tumor Hospital of Yunnan Province), Kunming, Yunnan, 650118, People's Republic of China.

ABSTRACT

Background: Various treatments of giant cell tumor of bone (GCTB) included in curettages and resections and with adjuvant are exerted, but the best treatment is controversial. The aim of the study was the identification of individual risk factors after various treatments in GCTB.

Methods: A total of 179 patients treated for GCTB between 1998 and 2010 were concluded in the retrospective study. All patients were treated with intralesional curettage, extensive curettage, or wide resection. Mean follow-up was 60.2 ± 18.7 months (36~112 months). Age, gender, tumor location, Campanacci grade, soft tissue extension, pathological features, and surgical methods were performed to univariate Kaplan-Meier survival analysis and multivariate Cox regression analysis.

Results: The local recurrence rates of intralesional curettage (41.9%) and extensive curettage (19.0%) were significantly higher than that of wide resection (7.7%). The higher risk of local recurrence was found for soft tissue extension (hazard = 7.921, 95% CI 1.107~56.671), compared with no statistical significances between gender, location, Campanacci grade, pathologic fracture, and local recurrences, which were shown by Kaplan-Meier analysis. However, recurrence-free survival (RFS) of patients younger than 30 was significantly lower than that of patients older than 30. The RFS of pathologic fracture patients with soft tissue extension was significantly lower than that of pathologic fracture patients without soft tissue extension. Multivariate Cox regression analysis indicated that the independent variable that contributed to recurrence-free survival was soft tissue extension and surgical methods. The RFS of extensive curettage had no statistically significant difference with wide resection and was significantly higher than that of intralesional curettage. Use of high-speed burring and bone cement significantly decreased the local recurrence rate.

Conclusions: Age (below 30 years), gender, tumor location, Campanacci grade, and pathologic fracture have no statistically significant influence on local recurrences. Soft tissue extension and intralesional curettage of surgical methods increased the RFS. The results of the present study suggested that compared with curettage and wide section, treatment of GCTB by extensive curettage could provide the favorable local control and functional recovery.

No MeSH data available.


Related in: MedlinePlus

Kaplan-Meier analysis and the log-rank test among the influence of different surgical methods
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Fig2: Kaplan-Meier analysis and the log-rank test among the influence of different surgical methods

Mentions: There was no significant difference in RFS between different genders, tumor locations, Campanacci grades, or pathological fracture conditions (Fig. 1a–c, f). However, the RFS of patients below 30 years was significantly lower than that of patients older than 30 years (Fig. 1d). And the RFS of patients with soft tissue extension was significantly lower than that of patients without (Fig. 1e). Regarding surgical methods, a different therapy had dramatic difference impact on the RFS (Table 2; Additional file 1: Table S2; Fig. 2) and the pattern was similar to that of the recurrence rate.Fig. 1


Surgery methods and soft tissue extension are the potential risk factors of local recurrence in giant cell tumor of bone.

Li D, Zhang J, Li Y, Xia J, Yang Y, Ren M, Liao Y, Yu S, Li X, Shen Y, Zhang Y, Yang Z - World J Surg Oncol (2016)

Kaplan-Meier analysis and the log-rank test among the influence of different surgical methods
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4837597&req=5

Fig2: Kaplan-Meier analysis and the log-rank test among the influence of different surgical methods
Mentions: There was no significant difference in RFS between different genders, tumor locations, Campanacci grades, or pathological fracture conditions (Fig. 1a–c, f). However, the RFS of patients below 30 years was significantly lower than that of patients older than 30 years (Fig. 1d). And the RFS of patients with soft tissue extension was significantly lower than that of patients without (Fig. 1e). Regarding surgical methods, a different therapy had dramatic difference impact on the RFS (Table 2; Additional file 1: Table S2; Fig. 2) and the pattern was similar to that of the recurrence rate.Fig. 1

Bottom Line: A total of 179 patients treated for GCTB between 1998 and 2010 were concluded in the retrospective study.The higher risk of local recurrence was found for soft tissue extension (hazard = 7.921, 95% CI 1.107~56.671), compared with no statistical significances between gender, location, Campanacci grade, pathologic fracture, and local recurrences, which were shown by Kaplan-Meier analysis.However, recurrence-free survival (RFS) of patients younger than 30 was significantly lower than that of patients older than 30.

View Article: PubMed Central - PubMed

Affiliation: Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Tumor Hospital of Yunnan Province), Kunming, Yunnan, 650118, People's Republic of China.

ABSTRACT

Background: Various treatments of giant cell tumor of bone (GCTB) included in curettages and resections and with adjuvant are exerted, but the best treatment is controversial. The aim of the study was the identification of individual risk factors after various treatments in GCTB.

Methods: A total of 179 patients treated for GCTB between 1998 and 2010 were concluded in the retrospective study. All patients were treated with intralesional curettage, extensive curettage, or wide resection. Mean follow-up was 60.2 ± 18.7 months (36~112 months). Age, gender, tumor location, Campanacci grade, soft tissue extension, pathological features, and surgical methods were performed to univariate Kaplan-Meier survival analysis and multivariate Cox regression analysis.

Results: The local recurrence rates of intralesional curettage (41.9%) and extensive curettage (19.0%) were significantly higher than that of wide resection (7.7%). The higher risk of local recurrence was found for soft tissue extension (hazard = 7.921, 95% CI 1.107~56.671), compared with no statistical significances between gender, location, Campanacci grade, pathologic fracture, and local recurrences, which were shown by Kaplan-Meier analysis. However, recurrence-free survival (RFS) of patients younger than 30 was significantly lower than that of patients older than 30. The RFS of pathologic fracture patients with soft tissue extension was significantly lower than that of pathologic fracture patients without soft tissue extension. Multivariate Cox regression analysis indicated that the independent variable that contributed to recurrence-free survival was soft tissue extension and surgical methods. The RFS of extensive curettage had no statistically significant difference with wide resection and was significantly higher than that of intralesional curettage. Use of high-speed burring and bone cement significantly decreased the local recurrence rate.

Conclusions: Age (below 30 years), gender, tumor location, Campanacci grade, and pathologic fracture have no statistically significant influence on local recurrences. Soft tissue extension and intralesional curettage of surgical methods increased the RFS. The results of the present study suggested that compared with curettage and wide section, treatment of GCTB by extensive curettage could provide the favorable local control and functional recovery.

No MeSH data available.


Related in: MedlinePlus