Recurrence of curetted and bone-grafted giant-cell tumours with and without adjuvant phenol therapy

Trieb, Klemens; Bitzan, Peter; Lang, Susanna; Dominkus, Martin; Kotz, R.

doi:10.1053/ejso.2000.1086

Cited by 126 publications

(106 citation statements)

References 11 publications

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“…phenol, alcohol, sterile water, heat, freezing, zinc, and hydrogen peroxide (Nicholson et al 1998, Malawer et al 1999, Trieb et al 2001, Ghert et al 2002, Ward and Li 2002, Haskell et al 2003, Zhen et al 2004. Recently, argon laser therapy has been added to the list (Lewis et al 2007).…”

Section: Discussionmentioning

confidence: 99%

Cement is recommended in intralesional surgery of giant cell tumors: A Scandinavian Sarcoma Group study of 294 patients followed for a median time of 5 years

Kivioja¹,

Blomqvist

Hietaniemi³

et al. 2008

Acta Orthopaedica

210

205

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Background Giant cell tumors of bone rarely metastasize but often recur locally after surgery. There is limited knowledge about the risk of recurrence related to different types of treatment.Patients and methods We analyzed factors affecting the local recurrence rate in 294 patients with giant cell tumors of the extremities using prospectively collected material from 13 centers. The median follow-up time was 5 (0.2-18) years.Results A local recurrence was diagnosed in 57 of 294 patients (19%). The overall 5-year local recurrence rate was 0.22. Univariate analysis identified young age and intralesional surgery to be associated with a higher risk of recurrence. Based on multivariate analysis, the relative risk was 2.4-fold for intralesional surgery compared to more extensive operative methods. There was no correlation between tumor size, tumor extension, sex of the patient, tumor location, or fracture at diagnosis and outcome. In the subgroup of 200 patients treated with intralesional surgery, the method of filling (cement or bone) was known for 194 patients and was statistically highly significant in favor of the use of cement.Interpretation Intralesional surgery should be the first choice in most giant cell tumors, even in the presence of a pathological fracture. After thorough evacuation, the cavity should be filled with cement.

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Section: Discussionmentioning

confidence: 99%

Cement is recommended in intralesional surgery of giant cell tumors: A Scandinavian Sarcoma Group study of 294 patients followed for a median time of 5 years

Kivioja¹,

Blomqvist

Hietaniemi³

et al. 2008

Acta Orthopaedica

210

205

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“…It is the least invasive surgical option and usually provides the possibility to save the joint adjacent to the tumor. Intralesional curettage may be combined with the use of local adjuncts, such as PMMA void filling [1,3,4,15,20,33,37,42,45], hydrogen peroxide [3,4], phenol [15,37,39,40,42], and cryotherapy [24,26,27] with the intention to further reduce the risk of local recurrence.…”

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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“…Protective devices are necessary to handle it, and electrocautery must be avoided during phenol application to avoid the risk of fire or explosion. On the other hand, Trieb et al [25] reported no significant reduction in the local recurrence rate after using phenol as an adjuvant. Cryosurgery using liquid nitrogen also presents the risk of considerable complications, such as fracture, adjacent tissue necrosis, failure of grafted bone to incorporate, and nerve injury [5].…”

Section: Discussionmentioning

confidence: 97%

“…Limb salvage procedures by allograft or tumour prosthesis may be performed for widely resected tumours. Moreover, recent reports indicate that aggressive curettage, often combined with adjuvant treatment, results in local recurrence rates of less than 10% [2,6,9,12,13,15,19,25]. The currently used adjuvants to kill tumour cells remaining after intralesional curettage include hydrogen peroxide (H 2 O 2 ), phenol, liquid nitrogen, distilled water, and electrocautery.…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment of giant cell tumour of long bone with anhydrous alcohol adjuvant

Yoon

Lee

et al. 2006

International Orthopaedics (SICOT)

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This study was designed to evaluate the feasibility and effectiveness of the use of anhydrous alcohol as an adjuvant treatment for giant cell tumours (GCTs) of long bone. Between October 1989 and January 2004, 42 GCT patients were treated and followed up for an average of 4.1 years (range 1-13 years). Mean patient age was 34 years (range 17-67 years). After curettage and additional burring, anhydrous alcohol was used as an adjuvant therapy in all patients before the bone defect was filled with bone graft or cement. Four patients (9.5%) experienced local recurrence. There were no alcohol-related complications. Recurrence-free probability was 87.6% at final follow-up (13 years) after index surgery by Kaplan-Meyer analysis. Our data suggest that anhydrous alcohol can be used as an effective safe adjuvant for the treatment of GCT of long bone.

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Recurrence of curetted and bone-grafted giant-cell tumours with and without adjuvant phenol therapy

Cited by 126 publications

References 11 publications

Cement is recommended in intralesional surgery of giant cell tumors: A Scandinavian Sarcoma Group study of 294 patients followed for a median time of 5 years

Cement is recommended in intralesional surgery of giant cell tumors: A Scandinavian Sarcoma Group study of 294 patients followed for a median time of 5 years

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

Surgical treatment of giant cell tumour of long bone with anhydrous alcohol adjuvant

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