Similar local recurrence but better function with curettage versus resection for bone giant cell tumor and pathological fracture at presentation.
Adult
Bone Neoplasms
/ pathology
Curettage
/ adverse effects
Cytoreduction Surgical Procedures
/ adverse effects
Female
Fractures, Spontaneous
/ etiology
Giant Cell Tumor of Bone
/ pathology
Humans
Male
Neoplasm Recurrence, Local
/ pathology
Postoperative Complications
Retrospective Studies
Young Adult
bone
curettage
giant cell tumor
local recurrence
pathological fracture
resection
Journal
Journal of surgical oncology
ISSN: 1096-9098
Titre abrégé: J Surg Oncol
Pays: United States
ID NLM: 0222643
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
received:
18
12
2018
accepted:
23
01
2019
pubmed:
9
2
2019
medline:
15
5
2019
entrez:
9
2
2019
Statut:
ppublish
Résumé
There are conflicting reports for the outcome of the patients with giant cell tumor of bone (GCTB) and pathological fracture at presentation treated with curettage or resection. This study compared local recurrence, complications, and function after curettage versus resection for these patients. We retrospectively studied the files of 46 patients with histologically confirmed GCTB of the extremities admitted and treated from 1982 to 2015. The median follow-up was 79.5 months (57.0-125.5 months). We evaluated local recurrence and type of surgery-related complications with imaging and function with the Musculoskeletal Tumor Society (MSTS) score. Overall local recurrence was 6.5%. There were one patient with curettage and two patients with resection; local recurrence rate was similar between the two procedures but the time to local recurrence was shorter after curettage. MSTS score was significantly better after curettage. Complications occurred in two patients after curettage and in five patients after resection; because of the low number of patients with complications, a statistical comparison was not possible; however, by direct comparison of the numbers, complications were more common after resection compared with curettage. Curettage is recommended for GCTB and pathological fracture at presentation because of similar local recurrence but better function compared with resection. The treating physicians should be aware and inform their patients for a shorter time to local recurrence after curettage and for more complications after resection.
Sections du résumé
BACKGROUND
BACKGROUND
There are conflicting reports for the outcome of the patients with giant cell tumor of bone (GCTB) and pathological fracture at presentation treated with curettage or resection. This study compared local recurrence, complications, and function after curettage versus resection for these patients.
MATERIALS AND METHODS
METHODS
We retrospectively studied the files of 46 patients with histologically confirmed GCTB of the extremities admitted and treated from 1982 to 2015. The median follow-up was 79.5 months (57.0-125.5 months). We evaluated local recurrence and type of surgery-related complications with imaging and function with the Musculoskeletal Tumor Society (MSTS) score.
RESULTS
RESULTS
Overall local recurrence was 6.5%. There were one patient with curettage and two patients with resection; local recurrence rate was similar between the two procedures but the time to local recurrence was shorter after curettage. MSTS score was significantly better after curettage. Complications occurred in two patients after curettage and in five patients after resection; because of the low number of patients with complications, a statistical comparison was not possible; however, by direct comparison of the numbers, complications were more common after resection compared with curettage.
CONCLUSION
CONCLUSIONS
Curettage is recommended for GCTB and pathological fracture at presentation because of similar local recurrence but better function compared with resection. The treating physicians should be aware and inform their patients for a shorter time to local recurrence after curettage and for more complications after resection.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
864-872Informations de copyright
© 2019 Wiley Periodicals, Inc.