Local control of long bone giant cell tumour using curettage, burring and bone grafting without adjuvant therapy

Malek, Fatemeh; Krueger, P; Hatmi, Z N; Malayeri, A. A.; Faezipour, H; O’Donnell, Richard J.

doi:10.1007/s00264-006-0146-3

Cited by 69 publications

(92 citation statements)

References 20 publications

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“…In 90% of cases the tumour occurs in the long bones, especially near the epiphysis. Approximately 8% of all giant cell tumours involve the distal part of the radius [1][2][3][4][5]. The aim of treatment is complete removal of the tumour and preservation of the maximum function of the extremity.…”

Section: Discussionmentioning

confidence: 99%

“…Curettage alone or with bone grafting has been associated with a high incidence of local recurrence in grade III giant cell tumour and rates of recurrence between 28 and 85% have been reported in some studies [2][3][4][5][6]. We agree that curettage alone may not be the best treatment option for grade III giant cell tumours, but it works very well in most of the grade I and II tumours [3,7]. Lower rates of local recurrence have been noted after wide resection of the diseased bone of grade III; a complex reconstruction procedure (arthroplasty) or arthrodesis of the wrist is required.…”

Section: Discussionmentioning

confidence: 99%

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Reconstruction of distal radius by fibula following excision of grade III giant cell tumour: Follow-up of 18 cases

Sun

Jia

2010

International Orthopaedics (SICOT)

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The purpose of this study was to evaluate the long-term results of vascularised fibular graft for reconstruction of the wrist after excision of grade III giant cell tumour in the distal radius. From January 1998 to September 2003, 18 patients with wrist defects due to distal radius grade III giant cell tumour resection were treated with vascularised fibular graft and were followedup. The limb function was restored to an average 80% of normal function and bone union was achieved within six months in 18 patients with vascularised fibular graft. MSTS score averaged 25.6 and ranged between 21 and 29; Mayo wrist score averaged 56 with a range from 40 to 65. It is appropriate to use the head of the fibula as a substitute for the distal radius. The healing of vascularised fibular graft is very quick and without bone resorption. Thus, in the procedure for reconstruction and limb salvage after bone tumour resection of distal radius, the free vascularised fibular graft with fibular head is an ideal substitute.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Reconstruction of distal radius by fibula following excision of grade III giant cell tumour: Follow-up of 18 cases

Sun

Jia

2010

International Orthopaedics (SICOT)

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“…Depending on the type of treatment and the local presentation of the tumor, recurrence rates of a primary GCT range from 0% to 65% [1,4,6,7,18,21,22,25,29,32,33,35,37,42]. Despite their generally benign nature, GCTs are able to seed lung metastases.…”

Section: Introductionmentioning

confidence: 99%

Recurrent Giant Cell Tumor of Long Bones: Analysis of Surgical Management

Klenke

Wenger

Inwards

et al. 2011

Clinical Orthopaedics &Amp; Related Research

115

106

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Background Treatment of giant cell tumor of bone (GCT) often is complicated by local recurrence. Intralesional curettage is the standard of care for primary GCTs. However, there is controversy whether intralesional curettage should be preferred over wide resection in recurrent GCTs. Questions/purposes We investigated the rerecurrencefree survival after surgical treatment of recurrent GCTs to determine the influence of the surgical approach, adjuvant treatment, local tumor presentation, and demographic factors on the risk of further recurrence. Patients and Methods We retrospectively reviewed the medical records of 46 patients with recurrent GCTs of long bones treated with wide resection or intralesional curettage and compared these cohorts. Recurrence rates, risk factors for recurrence, and the development of pulmonary metastases were determined. The minimum followup was 37 months (mean, 134 months; range, 37-337 months).

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“…All patients were alive at the end of the study; thus, no patients were censored for death. Univariate analysis for metastasis-free survival and recurrence-free survival rates was conducted using the Kaplan-Meier method, 7 and the log-rank test was used for comparisons with alpha set to P ¼ 0.05. Only one significant factor was identified for each outcome using univariate analysis.…”

Section: Discussionmentioning

confidence: 99%

“…2,6 Controversies exist regarding treatment protocols. 7 Thus, parameters that predict recurrence potential at initial diagnosis may be clinically useful to guide management.…”

mentioning

confidence: 99%

Distribution and prognostic significance of human telomerase reverse transcriptase (hTERT) expression in giant-cell tumor of bone

et al. 2008

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Giant-cell tumor of bone is considered a benign, locally aggressive and rarely metastasizing neoplasm of bone. Specific microscopic or radiographic findings that reliably predict behavior have remained elusive. However, recent evidence suggests that activity of the telomerase enzyme complex correlates with recurrence in giant-cell tumor, although the subset of cells with telomerase activity in these heterogeneous tumors has not been defined. In the present study, we investigated whether immunostaining for human telomerase reverse transcriptase, a component of the telomerase complex, correlates with outcome in giant-cell tumor and the distribution of telomerase reverse transcriptase staining in these tumors. We analyzed 58 cases of giant-cell tumor for the presence and pattern of telomerase reverse transcriptase immunostaining, presence of soft tissue involvement and the type of initial surgery, and correlated these findings with recurrence-free survival and metastasis-free survival. Specific staining with telomerase reverse transcriptase was present in 20 out of 58 tumors (35%) in the nuclei of mononuclear cells and, occasionally, osteoclast-like giant cells. Furthermore, positive telomerase reverse transcriptase immunohistochemistry correlated with recurrence-free survival (P ¼ 0.02), whereas the presence of soft tissue extension (P ¼ 0.3) and the type of initial surgery (P ¼ 0.2) did not. Only soft-tissue extension significantly correlated with metastasis-free survival (P ¼ 0.003). Therefore, telomerase reverse transcriptase expression may predict recurrence in giant-cell tumor insofar as positive immunostaining correlates with shorter recurrence-free survival and may be a useful prognostic marker to stratify patients to more aggressive treatment protocols.

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Local control of long bone giant cell tumour using curettage, burring and bone grafting without adjuvant therapy

Abstract: Giant cell tumour

Cited by 69 publications

References 20 publications

Reconstruction of distal radius by fibula following excision of grade III giant cell tumour: Follow-up of 18 cases

Reconstruction of distal radius by fibula following excision of grade III giant cell tumour: Follow-up of 18 cases

Recurrent Giant Cell Tumor of Long Bones: Analysis of Surgical Management

Distribution and prognostic significance of human telomerase reverse transcriptase (hTERT) expression in giant-cell tumor of bone

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