Higher local recurrence rates after intralesional surgery for giant cell tumor of the proximal femur compared to other sites.

Costantino Errani, Shinji Tsukamoto, Giulio Leone, Manabu Akahane, Luca Cevolani, Piergiuseppe Tanzi, Akira Kido, Kanya Honoki, Yasuhito Tanaka, Davide Maria Donati

Research output: Contribution to journalArticle

Abstract

The treatment of giant cell tumor (GCT) of bone remains controversial. Intralesional surgery (curettage) results in a higher rate of local recurrence, but better functional results compared to resection. The aim of this study was to assess whether the use of curettage was successful in the treatment of GCT of long bones. We evaluated the influence of adjuvant treatment, local tumor presentation, and demographic factors on the risk of recurrence.
METHODS:
We retrospectively reviewed the records of patients treated for GCT of long bones between 1990 and 2013, using curettage. No patient had any treatment other than surgery. After detailed curettage, the bone cavity was filled with bone allografts and/or cement. Recurrence rates, risk factors for recurrence and the development of pulmonary metastases were determined. The minimum follow-up was 24 months.
RESULTS:
We enrolled 210 patients with GCT of long bones treated by curettage. The rate of local recurrence was 16.2% (34/210 patients). The median follow-up was 89.2 months. In the multivariate analysis, no significant statistical effect on the local recurrence rate could be identified for gender, patient's age, Campanacci's grading, or cement versus bone allografts. The only independent risk factor related to the local recurrence was the site, with a statistically significant higher risk for patients with GCT of the proximal femur.
CONCLUSIONS:
Our observation on the correlation of tumor location and risk of local recurrence is new. We suggest that patients with GCT of bone in the proximal femur should be followed closely soon after surgery to identify any possible recurrence.
Original languageEnglish
Pages (from-to)813-819
Number of pages7
JournalEuropean Journal of Orthopaedic Surgery and Traumatology
Volume27
Issue number6
Publication statusPublished - Jun 6 2017

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Giant Cell Tumors
Femur
Giant Cell Tumor of Bone
Curettage
Recurrence
Allografts
Bone and Bones
Bone Cements
Therapeutics
Neoplasms
Multivariate Analysis
Demography
Neoplasm Metastasis
Lung

Keywords

  • Benign bone tumor
  • Curettage
  • Giant cell tumor
  • Surgery

Cite this

Higher local recurrence rates after intralesional surgery for giant cell tumor of the proximal femur compared to other sites. / Errani, Costantino; Tsukamoto, Shinji; Leone, Giulio; Akahane, Manabu; Cevolani, Luca; Tanzi, Piergiuseppe; Kido, Akira; Honoki, Kanya; Tanaka, Yasuhito; Donati, Davide Maria.

In: European Journal of Orthopaedic Surgery and Traumatology, Vol. 27, No. 6, 06.06.2017, p. 813-819.

Research output: Contribution to journalArticle

Errani, Costantino ; Tsukamoto, Shinji ; Leone, Giulio ; Akahane, Manabu ; Cevolani, Luca ; Tanzi, Piergiuseppe ; Kido, Akira ; Honoki, Kanya ; Tanaka, Yasuhito ; Donati, Davide Maria. / Higher local recurrence rates after intralesional surgery for giant cell tumor of the proximal femur compared to other sites. In: European Journal of Orthopaedic Surgery and Traumatology. 2017 ; Vol. 27, No. 6. pp. 813-819.
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title = "Higher local recurrence rates after intralesional surgery for giant cell tumor of the proximal femur compared to other sites.",
abstract = "The treatment of giant cell tumor (GCT) of bone remains controversial. Intralesional surgery (curettage) results in a higher rate of local recurrence, but better functional results compared to resection. The aim of this study was to assess whether the use of curettage was successful in the treatment of GCT of long bones. We evaluated the influence of adjuvant treatment, local tumor presentation, and demographic factors on the risk of recurrence.METHODS:We retrospectively reviewed the records of patients treated for GCT of long bones between 1990 and 2013, using curettage. No patient had any treatment other than surgery. After detailed curettage, the bone cavity was filled with bone allografts and/or cement. Recurrence rates, risk factors for recurrence and the development of pulmonary metastases were determined. The minimum follow-up was 24 months.RESULTS:We enrolled 210 patients with GCT of long bones treated by curettage. The rate of local recurrence was 16.2{\%} (34/210 patients). The median follow-up was 89.2 months. In the multivariate analysis, no significant statistical effect on the local recurrence rate could be identified for gender, patient's age, Campanacci's grading, or cement versus bone allografts. The only independent risk factor related to the local recurrence was the site, with a statistically significant higher risk for patients with GCT of the proximal femur.CONCLUSIONS:Our observation on the correlation of tumor location and risk of local recurrence is new. We suggest that patients with GCT of bone in the proximal femur should be followed closely soon after surgery to identify any possible recurrence.",
keywords = "Benign bone tumor, Curettage, Giant cell tumor, Surgery",
author = "Costantino Errani and Shinji Tsukamoto and Giulio Leone and Manabu Akahane and Luca Cevolani and Piergiuseppe Tanzi and Akira Kido and Kanya Honoki and Yasuhito Tanaka and Donati, {Davide Maria}",
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T1 - Higher local recurrence rates after intralesional surgery for giant cell tumor of the proximal femur compared to other sites.

AU - Errani, Costantino

AU - Tsukamoto, Shinji

AU - Leone, Giulio

AU - Akahane, Manabu

AU - Cevolani, Luca

AU - Tanzi, Piergiuseppe

AU - Kido, Akira

AU - Honoki, Kanya

AU - Tanaka, Yasuhito

AU - Donati, Davide Maria

PY - 2017/6/6

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N2 - The treatment of giant cell tumor (GCT) of bone remains controversial. Intralesional surgery (curettage) results in a higher rate of local recurrence, but better functional results compared to resection. The aim of this study was to assess whether the use of curettage was successful in the treatment of GCT of long bones. We evaluated the influence of adjuvant treatment, local tumor presentation, and demographic factors on the risk of recurrence.METHODS:We retrospectively reviewed the records of patients treated for GCT of long bones between 1990 and 2013, using curettage. No patient had any treatment other than surgery. After detailed curettage, the bone cavity was filled with bone allografts and/or cement. Recurrence rates, risk factors for recurrence and the development of pulmonary metastases were determined. The minimum follow-up was 24 months.RESULTS:We enrolled 210 patients with GCT of long bones treated by curettage. The rate of local recurrence was 16.2% (34/210 patients). The median follow-up was 89.2 months. In the multivariate analysis, no significant statistical effect on the local recurrence rate could be identified for gender, patient's age, Campanacci's grading, or cement versus bone allografts. The only independent risk factor related to the local recurrence was the site, with a statistically significant higher risk for patients with GCT of the proximal femur.CONCLUSIONS:Our observation on the correlation of tumor location and risk of local recurrence is new. We suggest that patients with GCT of bone in the proximal femur should be followed closely soon after surgery to identify any possible recurrence.

AB - The treatment of giant cell tumor (GCT) of bone remains controversial. Intralesional surgery (curettage) results in a higher rate of local recurrence, but better functional results compared to resection. The aim of this study was to assess whether the use of curettage was successful in the treatment of GCT of long bones. We evaluated the influence of adjuvant treatment, local tumor presentation, and demographic factors on the risk of recurrence.METHODS:We retrospectively reviewed the records of patients treated for GCT of long bones between 1990 and 2013, using curettage. No patient had any treatment other than surgery. After detailed curettage, the bone cavity was filled with bone allografts and/or cement. Recurrence rates, risk factors for recurrence and the development of pulmonary metastases were determined. The minimum follow-up was 24 months.RESULTS:We enrolled 210 patients with GCT of long bones treated by curettage. The rate of local recurrence was 16.2% (34/210 patients). The median follow-up was 89.2 months. In the multivariate analysis, no significant statistical effect on the local recurrence rate could be identified for gender, patient's age, Campanacci's grading, or cement versus bone allografts. The only independent risk factor related to the local recurrence was the site, with a statistically significant higher risk for patients with GCT of the proximal femur.CONCLUSIONS:Our observation on the correlation of tumor location and risk of local recurrence is new. We suggest that patients with GCT of bone in the proximal femur should be followed closely soon after surgery to identify any possible recurrence.

KW - Benign bone tumor

KW - Curettage

KW - Giant cell tumor

KW - Surgery

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SP - 813

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JO - European Journal of Orthopaedic Surgery and Traumatology

JF - European Journal of Orthopaedic Surgery and Traumatology

SN - 1633-8065

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ER -