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01-08-2015 | Original Article

Treatment and outcome of primary aggressive giant cell tumor in the spine

Authors: Huabin Yin, Xinghai Yang, Wei Xu, Binbin Li, Bo Li, Ting Wang, Tong Meng, Peng Wang, Tielong Liu, Wang Zhou, Jianru Xiao

Published in: European Spine Journal | Issue 8/2015

Abstract

Purpose

Aggressive giant cell tumor (GCT) is an important subtype of GCT and is relatively rare in the spine. There is little published information regarding this subject. The objective of our study is to discuss prognostic factors for primary aggressive GCT in the spine.

Methods

A retrospective study of patients who had primary aggressive GCT in the spine and underwent surgical treatment at our center between 2000 and 2012 was conducted. Univariate and multivariate analyses were performed to identify the factors that might affect recurrence. T test, Chi-square test and rank sum test were used to analyze a single factor for recurrence, and factors with P ≤ 0.1 were subjected to multivariate analyses by binary logistic regression analyses. P values of ≤0.05 were considered statistically significant.

Results

A total of 71 patients with primary aggressive GCT in the spine were included in the study. The mean follow-up period was 73.9 (range 23–167) months. Recurrence was detected in 24 patients after the initial surgery in our center with a recurrence rate of 33.8 %. The statistical analyses suggested that age more than 40 years, pathology grade III, total en bloc spondylectomy, and bisphosphonate treatment were independent prognostic factors for recurrence of primary aggressive GCT in the spine.

Conclusion

Total en bloc spondylectomy together with bisphosphonate treatment could significantly decrease recurrence risk of primary aggressive GCT in the spine. Jaffe grade III was an adverse prognostic factor for recurrence, while age less than 40 years was a favorable prognostic factor.

Gupta R, Seethalakshmi V, Jambhekar NA et al (2008) Clinicopathologic profile of 470 giant cell tumors of bone from a cancer hospital in western India. Ann Diagn Pathol. 12(4):239–248PubMedCrossRef

Xu W, Li X, Huang W et al (2013) Factors affecting prognosis of patients with giant cell tumors of the mobile spine: retrospective analysis of 102 patients in a single center. Ann Surg Oncol 20(3):804–810PubMedCrossRef

Wu Z, Yang X, Xiao J et al (2011) Aneurysmal bone cyst secondary to giant cell tumor of the mobile spine: a report of 11 cases. Spine (Phila Pa 1976) 36(21):E1385–E1390CrossRef

Wu Z, Yin H, Liu T et al (2014) MiR-126-5p regulates osteoclast differentiation and bone resorption in giant cell tumor through inhibition of MMP-13. Biochem Biophys Res Commun. 443(3):944–949PubMedCrossRef

Sanjay BK, Sim FH, Unni KK et al (1993) Giant-cell tumours of the spine. J Bone Joint Surg Br 75(1):148–154PubMed

Dahlin DC (1985) Caldwell lecture. Giant cell tumor of bone: highlights of 407 cases. AJR Am J Roentgenol 144(5):955–960PubMedCrossRef

Sanerkin NG (1980) Malignancy, aggressiveness, and recurrence in giant cell tumor of bone. Cancer 46(7):1641–1649PubMedCrossRef

Rock MG, Pritchard DJ, Unni KK (1984) Metastases from histologically benign giant-cell tumor of bone. J Bone Joint Surg Am 66(2):269–274PubMed

Boriani S, Bandiera S, Casadei R et al (2012) Giant cell tumor of the mobile spine: a review of 49 cases. Spine (Phila Pa 1976) 37(1):E37–E45CrossRef

10.

Campanacci M, Baldini N, Boriani S et al (1987) Giant-cell tumor of bone. J Bone Joint Surg Am 69(1):106–114PubMed

11.

Enneking WF (1986) A system of staging musculoskeletal neoplasms. Clin Orthop Relat Res 204:9–24PubMed

12.

Puloski SK, Griffin A, Ferguson PC et al (2007) Functional outcomes after treatment of aggressive tumors in the distal radius. Clin Orthop Relat Res 459:154–160PubMedCrossRef

13.

Flouzat-Lachaniette CH, Babinet A, Kahwaji A et al (2013) Limited arthrodesis of the wrist for treatment of giant cell tumor of the distal radius. J Hand Surg Am 38(8):1505–1512PubMedCrossRef

14.

Boriani S, Weinstein JN, Biagini R (1997) Primary bone tumors of the spine. Terminology and surgical staging. Spine (Phila Pa 1976) 22(9):1036–1044CrossRef

15.

Martin C, McCarthy EF (2010) Giant cell tumor of the sacrum and spine: series of 23 cases and a review of the literature. Iowa Orthop J 30:69–75PubMedCentralPubMed

16.

Junming M, Cheng Y, Dong C et al (2008) Giant cell tumor of the cervical spine: a series of 22 cases and outcomes. Spine (Phila Pa 1976) 33(3):280–288CrossRef

17.

Savini R, Gherlinzoni F, Morandi M et al (1983) Surgical treatment of giant-cell tumor of the spine. The experience at the Istituto Ortopedico Rizzoli. J Bone Joint Surg Am 65(9):1283–1289PubMed

18.

Frankel HL, Hancock DO, Hyslop G et al (1969) The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia. I. Paraplegia 7(3):179–192PubMedCrossRef

19.

Jaffe HL, Lichtenstein L, Portis RB (1940) Giant cell tumor of bone. Its pathologic appearance, grading, supposed variants and treatment. Arch Pathol 30:993–1031

20.

Boriani S, Biagini R, De Iure F et al (1996) En bloc resections of bone tumors of the thoracolumbar spine. A preliminary report on 29 patients. Spine (Phila Pa 1976) 21(16):1927–1931CrossRef

21.

Tomita K, Kawahara N, Baba H et al (1997) Total en bloc spondylectomy. A new surgical technique for primary malignant vertebral tumors. Spine (Phila Pa 1976) 22(3):324–333CrossRef

22.

Yin H, Zhang D, Wu Z et al (2014) Desmoplastic fibroma of the spine: a series of 12 cases and outcomes. Spine J 14(8):1622–1628PubMedCrossRef

23.

Yin H, Zhou W, Meng J et al (2014) Prognostic factors of patients with spinal chondrosarcoma: a retrospective analysis of 98 consecutive patients in a single center. Ann Surg Oncol 21(11):3572–3578PubMedCrossRef

24.

Cheng YY, Huang L, Lee KM et al (2004) Bisphosphonates induce apoptosis of stromal tumor cells in giant cell tumor of bone. Calcif Tissue Int 75(1):71–77PubMed

25.

Chang SS, Suratwala SJ, Jung KM et al (2004) Bisphosphonates may reduce recurrence in giant cell tumor by inducing apoptosis. Clin Orthop Relat Res 426:103–109PubMedCrossRef

26.

Balke M, Campanacci L, Gebert C et al (2010) Bisphosphonate treatment of aggressive primary, recurrent and metastatic Giant Cell Tumour of Bone. BMC Cancer 29(10):462CrossRef

27.

Zhang W, Zhang Y, Li P et al (2011) Administration of sodium ibandronate in the treatment of complicated giant cell tumor of the spine. Spine (Phila Pa 1976) 36(17):E1166–E1172CrossRef

28.

Vander Griend RA, Funderburk CH (1993) The treatment of giant-cell tumors of the distal part of the radius. J Bone Joint Surg Am 75(6):899–908PubMed

29.

Noellert RC, Louis DS (1985) Long-term follow-up of nonvascularized fibular autografts for distal radial reconstruction. J Hand Surg Am 10(3):335–340PubMedCrossRef

30.

Murray JA, Schlafly B (1986) Giant-cell tumors in the distal end of the radius. Treatment by resection and fibular autograft interpositional arthrodesis. J Bone Joint Surg Am 68(5):687–694PubMed

31.

Boriani S, Bandiera S, Donthineni R et al (2010) Morbidity of en bloc resections in the spine. Eur Spine J 19(2):231–241PubMedCentralPubMedCrossRef

32.

Bandiera S, Boriani S, Donthineni R et al (2009) Complications of en bloc resections in the spine. Orthop Clin North Am 40(1):125–131PubMedCrossRef

33.

McDonnell MF, Glassman SD, Dimar JR 2nd et al (1996) Perioperative complications of anterior procedures on the spine. J Bone Joint Surg Am 78(6):839–847PubMed

34.

Tse LF, Wong KC, Kumta SM et al (2008) Bisphosphonates reduce local recurrence in extremity giant cell tumor of bone: a case-control study. Bone 42(1):68–73PubMedCrossRef

35.

Raskin KA, Schwab JH, Mankin HJ et al (2013) Giant cell tumor of bone. J Am Acad Orthop Surg 21(2):118–126PubMedCrossRef

36.

Shi W, Indelicato DJ, Reith J et al (2013) Radiotherapy in the management of giant cell tumor of bone. Am J Clin Oncol 36(5):505–508PubMedCrossRef

37.

Griffin AM, Ferguson PC, Catton CN et al (2012) Long-term outcome of the treatment of high-risk tenosynovial giant cell tumor/pigmented villonodular synovitis with radiotherapy and surgery. Cancer 118(19):4901–4909PubMedCrossRef

38.

Zhen W, Yaotian H, Songjian L et al (2004) Giant-cell tumour of bone. The long-term results of treatment by curettage and bone graft. J Bone Joint Surg Br 86(2):212–216PubMedCrossRef

39.

Dürr HR, Maier M, Jansson V et al (1999) Phenol as an adjuvant for local control in the treatment of giant cell tumour of the bone. Eur J Surg Oncol 25(6):610–618PubMedCrossRef

40.

Malawer MM, Bickels J, Meller I et al (1999) Cryosurgery in the treatment of giant cell tumor. A long-term followup study. Clin Orthop Relat Res 359:176–188PubMedCrossRef

41.

Ozkan E, Gupta S (2011) Embolization of spinal tumors: vascular anatomy, indications, and technique. Tech Vasc Interv Radiol 14(3):129–140PubMedCrossRef

42.

Vetter SC, Strecker EP, Ackermann LW et al (1997) Preoperative embolization of cervical spine tumors. Cardiovasc Intervent Radiol 20(5):343–347PubMedCrossRef

Title: Treatment and outcome of primary aggressive giant cell tumor in the spine
Authors: Huabin Yin
Xinghai Yang
Wei Xu
Binbin Li
Bo Li
Ting Wang
Tong Meng
Peng Wang
Tielong Liu
Wang Zhou
Jianru Xiao
Publication date: 01-08-2015
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 8/2015
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-015-3777-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Treatment and outcome of primary aggressive giant cell tumor in the spine

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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