Giant Cell Tumor of Bone: 413 Patients, Analysis of Recurrence Rate and Local Recurrence Risk Factors

OrthoMedia ◽  
2021 ◽  
Keyword(s):  
Risk Factors ◽  
Local Recurrence ◽  
Giant Cell Tumor ◽  
Giant Cell ◽  
Recurrence Rate ◽  
Recurrence Risk ◽  
Cell Tumor

Staged sacrectomy—an adaptive approach

2009 ◽  
Vol 11 (3) ◽  
pp. 285-294 ◽  
Author(s):  
Rajaraman Ramamurthy ◽  
Jagadish Chandra Bose ◽  
Vimalakannan Muthusamy ◽  
Mayilvahanan Natarajan ◽  
Deiveegan Kunjithapatham
Keyword(s):  
Survival Rate ◽  
Local Recurrence ◽  
Blood Loss ◽  
Giant Cell Tumor ◽  
Giant Cell ◽  
Recurrence Rate ◽  
Local Recurrence Rate ◽  
Cell Tumor ◽  
Wound Complications ◽  
Kaplan Meier

Object Sacral tumors are commonly diagnosed late and therefore present at an advanced stage. The late presentation makes curative surgery technically demanding. Sacrectomy is fraught with a high local recurrence rate and potential complications: deep infection; substantial blood loss; large-bone and soft-tissue defects; bladder, bowel, and sexual dysfunction; spinopelvic nonunion; and gait disturbance. The aim of this study was to analyze the complications and morbidity of sacrectomy and the modifications meant to reduce the morbidity. Methods This is a retrospective study of the patients who underwent sacrectomy between February 1997 and September 2008 in the Department of Surgical Oncology, Government Royapettah Hospital, Kilpauk Medical College, in Chennai, Tamilnadu, India. Sacrectomy was performed using 1 of the following approaches: posterior approach, abdominolateral approach, or abdominosacral approach, either as sequential or staged operations. The morbidity rate after the sequential and staged abdominosacral approaches was analyzed. Functional assessment was made based on the Enneking functional scoring system. The results were analyzed and survival analysis was done using the Kaplan-Meier method (with SPSS software). Results Nineteen patients underwent sacrectomy, of which 12 operations were partial, 3 were subtotal, and 4 were total sacrectomy. Histological diagnosis included giant cell tumor, chordoma, chondroblastoma, adenocarcinoma of rectum, and retroperitoneal sarcoma. The giant cell tumor was the most common tumor in this series, followed by chordoma. The patients' mean age at diagnosis was 32 years. There were 10 male and 9 female patients. Fortyseven percent of patients had bowel and bladder disturbances postoperatively, and 57.89% of patients had wound complications. The median follow-up duration was 24 months (range 2–140 months). The 5-year overall survival rate was 70.4%, and the 5-year disease-free survival rate was 65% (based on the Kaplan-Meier method). The local recurrence rate (5 cases) was 26.32%. The median duration for first recurrence was 12 months (range 3–17 months). Distant metastasis occurred in 1 patient (5.26%), and 4 patients died, 1 of them due to pulmonary thromboembolism, in the postoperative period. Based on the Enneking system of functional evaluation, 5 patients (26.32%) had excellent outcome, 6 (31.57%) had good outcome, 5 (26.32%) had fair outcome, and 3 (15.78%) had poor outcome. Spinopelvic reconstruction was not performed in any of the patients, and all were ambulatory postoperatively. The staged abdominosacral approach has markedly reduced patient morbidity in terms of reduction of operating time, blood loss, anesthesia complications, and wound complications. Conclusions Sacrectomy, a dreaded operation that often results in morbidity, is now feasible with modifications and improvement in surgical technique. The staged abdominosacral approach reduces the immediate postoperative morbidity. Use of a gluteal advancement flap reduces the incidence of wound complications. With modern surgical facilities and postoperative care, sacrectomy is feasible via the staged abdominosacral approach.

scholarly journals Comparative Analysis of Two Surgical Treatment Options for Giant Cell Tumor of the Proximal Femur: Extended Curettage and Segmental Resection

2021 ◽  
Vol 11 ◽  
Author(s):  
Yuhao Yuan ◽  
Qing Liu ◽  
Yupeng Liu ◽  
Ziyi Wu ◽  
Wei Zhong ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Local Recurrence ◽  
Giant Cell Tumor ◽  
Giant Cell ◽  
Recurrence Rate ◽  
Proximal Femur ◽  
Cell Tumor ◽  
Evaluation Standard ◽  
Msts Score ◽  
Extended Curettage

AimAs a locally destructive intermediate bone tumor with low incidence, high recurrence rate, and difficulty in reconstruction, giant cell tumor of bone (GCTB) in the proximal femur has no unified surgical treatment standard. This study aimed to compare the differences in local recurrence, reconstruction durability, and postoperative function after treatment with either extended curettage (EC) or segmental resection (SR) for GCTB in the proximal femur so as to provide constructive suggestions for the rational selection of EC or SR operation scheme.Patients and Methods29 patients (15 men and 14 women) were included in this retrospective study, with a mean age of 32.1 years. According to the division method of proximal femur of International Society Of Limb Salvage (ISOLS), there was 1 case in the H1 area, 17 cases in the H2 area, 10 cases in the H1+H2 area, and 1 case in the H1+H2+H3 area. Among them were 11 cases of Campanacci grade II GCTB, 18 cases of Campanacci grade III GCTB, and 7 cases with pathological fractures. All patients underwent either EC or SR surgery. The Musculoskeletal Tumor Society (MSTS) score was used for patient evaluation. The operation effectiveness was analyzed according to the Mankin evaluation standard. Regular follow-up was performed to evaluate the recurrence rate, limb function, and long-term complications of the two surgical methods.ResultsAll patients were followed up for a mean of 60.4 months. Local recurrence occurred in one of 19 patients treated with EC (5.3%) and one of 10 patients treated with SR (10%). The MSTS score of lower limb function in patients in the EC group was better compared to patients in the SR group (P = 0.002). Complications occurred in 2 cases (10.5%) and 5 cases (50%) in the EC group (osteoarthritis, osteonecrosis) and SR group (joint stiffness, infection, prosthesis loosening), respectively, with significant differences between the two groups (P = 0.03). The operation effectiveness was analyzed according to the Mankin evaluation standard. The EC group showed an optimal rate of 94.7% (18/19) as opposed to 80% (8/10) in the SR group.ConclusionsFor GCTB in the proximal femur, when the tumor does not extensively involves the surrounding soft tissues, the articular surface was not damaged, and there is no pathological fracture with apparent displacement, EC surgery should be fully considered.

Giant cell tumor of bone: effect of different surgical techniques and adjuvants on local recurrence rate

2003 ◽  
Vol 4 (3) ◽  
pp. 126-132 ◽  
Author(s):  
A. Gambini ◽  
L. Di Giorgio ◽  
M. Valeo ◽  
R. Trinchi ◽  
M. Marzolini ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Giant Cell Tumor ◽  
Giant Cell ◽  
Recurrence Rate ◽  
Local Recurrence Rate ◽  
Surgical Techniques ◽  
Cell Tumor ◽  
Bone Effect

scholarly journals Preoperative CT for prediction of local recurrence after curettage of giant cell tumor of bone

2021 ◽  
pp. 100366
Author(s):  
Lenian Zhou ◽  
Shanyi Lin ◽  
Hanqiang Jin ◽  
Zhaoyuan Zhang ◽  
Changqing Zhang ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Giant Cell Tumor ◽  
Giant Cell ◽  
Cell Tumor ◽  
Preoperative Ct

Clinical and pathological analysis of giant cell tumor of bone with denosumab treatment and local recurrence

2020 ◽  
Author(s):  
Kenta Hayashida ◽  
Yusuke Kawabata ◽  
Ikuma Kato ◽  
Takayuki Kamiishi ◽  
Kosuke Matsuo ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Giant Cell Tumor ◽  
Giant Cell ◽  
Cell Tumor ◽  
Pathological Analysis ◽  
Denosumab Treatment

Impact Severity of Local Recurrence in Giant Cell Tumor of Bone

2005 ◽  
Vol &NA; (438) ◽  
pp. 116-122 ◽  
Author(s):  
Richard L McGough ◽  
Janie Rutledge ◽  
Valerae O Lewis ◽  
Patrick P Lin ◽  
Alan W Yasko
Keyword(s):  
Local Recurrence ◽  
Giant Cell Tumor ◽  
Giant Cell ◽  
Cell Tumor

scholarly journals Multiple Pulmonary Metastases of Giant Cell Tumor of Bone with expression of VEGFR-2 Successfully Treated by Denosumab and Apatinib: A Rare Case Report

2021 ◽  
Author(s):  
taojun gong ◽  
Yi Luo ◽  
Yitian Wang ◽  
Chuanxi Zheng ◽  
Jianguo Fang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Local Recurrence ◽  
Giant Cell Tumor ◽  
Giant Cell ◽  
Pulmonary Metastases ◽  
Cell Tumor ◽  
Wide Resection ◽  
High Tendency ◽  
Bony Destruction

Abstract Background: Giant cell tumor of bone (GCTB) is a rare benign but locally aggressive bone tumor. It has a high tendency for local recurrence, which may increase the occurrence of lung metastasis. Currently, the treatment of pulmonary metastases of GCTB is controversial. Denosumab is the preferred regimen for unresectable metastatic lesions, but there are no alternative treatment options when denosumab is resistant. So far, no case reports of metastatic GCTB treated with denosumab and apatinib have been published. Case presentation: This is a case report of a 26-year-old female who experienced right knee pain for over 6 months. Radiography and computed tomography revealed osteolytic bony destruction in the proximal right tibia. Using histological, radiological, and clinical techniques, a diagnosis of GCTB was achieved. Meanwhile, the immunohistochemical stain-identified the tumor cells were positive for vascular endothelial growth factor receptor 2 (VEGFR-2). After intralesional curettage of the primary tumor and wide resection of local recurrence surgeries, she developed recurrent hemoptysis. Chest computed tomography (CT) images showed multiple pulmonary nodules. She was administrated denosumab therapy but disease progression was confirmed after four months of treatment. She then received denosumab and apatinib therapy for 24 months, after a partial response was achieved.Conclusions: We depict a case of multiple pulmonary metastases of GCTB successfully controlled by denosumab and apatinib therapy. VEGFR-2 may be an effective therapeutic target for GCTB with pulmonary metastasis when denosumab is ineffective.

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