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World Journal of Surgical Oncology
Published in: World Journal of Surgical Oncology 1/2016

Open Access 01-12-2016 | Research

Surgery methods and soft tissue extension are the potential risk factors of local recurrence in giant cell tumor of bone

Authors: Dongqi Li, Jinlei Zhang, Yi Li, Junfeng Xia, Yihao Yang, Mingyan Ren, Yedan Liao, Shunling Yu, Xiaojuan Li, Yan Shen, Ya Zhang, Zuozhang Yang

Published in: World Journal of Surgical Oncology | Issue 1/2016

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Abstract

Background

Various treatments of giant cell tumor of bone (GCTB) included in curettages and resections and with adjuvant are exerted, but the best treatment is controversial. The aim of the study was the identification of individual risk factors after various treatments in GCTB.

Methods

A total of 179 patients treated for GCTB between 1998 and 2010 were concluded in the retrospective study. All patients were treated with intralesional curettage, extensive curettage, or wide resection. Mean follow-up was 60.2 ± 18.7 months (36~112 months). Age, gender, tumor location, Campanacci grade, soft tissue extension, pathological features, and surgical methods were performed to univariate Kaplan-Meier survival analysis and multivariate Cox regression analysis.

Results

The local recurrence rates of intralesional curettage (41.9 %) and extensive curettage (19.0 %) were significantly higher than that of wide resection (7.7 %). The higher risk of local recurrence was found for soft tissue extension (hazard = 7.921, 95 % CI 1.107~56.671), compared with no statistical significances between gender, location, Campanacci grade, pathologic fracture, and local recurrences, which were shown by Kaplan-Meier analysis. However, recurrence-free survival (RFS) of patients younger than 30 was significantly lower than that of patients older than 30. The RFS of pathologic fracture patients with soft tissue extension was significantly lower than that of pathologic fracture patients without soft tissue extension. Multivariate Cox regression analysis indicated that the independent variable that contributed to recurrence-free survival was soft tissue extension and surgical methods. The RFS of extensive curettage had no statistically significant difference with wide resection and was significantly higher than that of intralesional curettage. Use of high-speed burring and bone cement significantly decreased the local recurrence rate.

Conclusions

Age (below 30 years), gender, tumor location, Campanacci grade, and pathologic fracture have no statistically significant influence on local recurrences. Soft tissue extension and intralesional curettage of surgical methods increased the RFS. The results of the present study suggested that compared with curettage and wide section, treatment of GCTB by extensive curettage could provide the favorable local control and functional recovery.
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Literature
1.
Faisham WI, Zulmi W, Halim AS, Biswal BM, Mutum SS, Ezane AM. Aggressive giant cell tumour of bone. Singapore Med J. 2006;47:679–83.PubMed
2.
Rockberg J, Bach BA, Amelio J, Hernandez RK, Sobocki P, Engellau J, Bauer HCF, Liede A. Incidence trends in the diagnosis of giant cell tumor of bone in Sweden since 1958. J Bone Joint Surg Am. 2015;97:1756–66.CrossRefPubMed
3.
4.
5.
Lackman RD, Hosalkar HS, Ogilvie CM, Torbert JT, Fox EJ. Intralesional curettage for grades II and III giant cell tumors of bone. Clin Orthop Relat Res. 2005;438:123–7.CrossRefPubMed
6.
7.
Chen J, Younusi A, Cao L, Xu L, Zhou Y, Zhen T, Song X. Serum levels of NTx and TRACP5b in giant cell tumor of bone and its clinical implications. Clin Lab. 2015;61:1077–81.PubMed
8.
Dong Z, Long M, Li H, Fu Y, Chen H. The relationship between surgical staging, pathologic grading, operative type and postoperative recurrence in giant cell tumor of bone. Hunan Yi Ke Da Xue Xue Bao. 1999;24:174–6.PubMed
9.
McGough RL, Rutledge J, Lewis VO, Lin PP, Yasko AW. Impact severity of local recurrence in giant cell tumor of bone. Clin Orthop Relat Res. 2005;438:116–22.CrossRefPubMed
10.
11.
Szendröi M. Giant-cell tumour of bone. J Bone Joint Surg (Br). 2004;86:5–12.
12.
Chang SS, Suratwala SJ, Jung KM, Doppelt JD, Zhang HZ, Blaine TA, Kim TW, Winchester RJ, Lee FY-I. Bisphosphonates may reduce recurrence in giant cell tumor by inducing apoptosis. Clin Orthop Relat Res. 2004;426:103–9.CrossRefPubMed
13.
Balke M, Ahrens H, Streitbuerger A, Koehler G, Winkelmann W, Gosheger G, Hardes J. Treatment options for recurrent giant cell tumors of bone. J Cancer Res Clin Oncol. 2009;135:149–58.CrossRefPubMed
14.
15.
Campanacci M, Baldini N, Boriani S, Sudanese A. Giant-cell tumor of bone. J Bone Joint Surg Am. 1987;69:106–14.PubMed
16.
Singh AS, Chawla NS, Chawla SP. Giant-cell tumor of bone: treatment options and role of denosumab. Biogeosciences. 2015;9:69–74.
17.
Becker W, Dohle J, Bernd L, Braun A, Cserhati M, Enderle A, Hovy L, Matejovsky Z, Szendroi M, Trieb K. Local recurrence of giant cell tumor of bone after intralesional treatment with and without adjuvant therapy. J Bone Joint Surg Am. 2008;90:1060–7.CrossRefPubMed
18.
Balke M, Schremper L, Gebert C, Ahrens H, Streitbuerger A, Koehler G, Hardes J, Gosheger G. Giant cell tumor of bone: treatment and outcome of 214 cases. J Cancer Res Clin Oncol. 2008;134:969–78.CrossRefPubMed
19.
Bergovec M, Petkovic M, Smerdelj M, Seiwerth S, Brkic L, Robert K, Orlic D. Giant cell tumor of bone: results and treatment complications. Acta Med Croatica. 2014;68:405–10.PubMed
20.
Kivioja AH, Blomqvist C, Hietaniemi K, Trovik C, Walloe A, Bauer HC, Jorgensen PH, Bergh P, Follerås G. 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. Acta Orthop. 2008;79:86–93.CrossRefPubMed
21.
Malek F, Krueger P, Hatmi Z, Malayeri A, Faezipour H, O’Donnell R. Local control of long bone giant cell tumour using curettage, burring and bone grafting without adjuvant therapy. Int Orthop. 2006;30:495–8.CrossRefPubMedPubMedCentral
22.
23.
Fletcher CD, Unni KK, Mertens F. Pathology and genetics of tumours of soft tissue and bone. World Health Organization classification of tumours 2013.
24.
Niu X, Zhang Q, Hao L, Ding Y, Li Y, Xu H, Liu W. Giant cell tumor of the extremity: retrospective analysis of 621 Chinese patients from one institution. J Bone Joint Surg Am. 2012;94:461–7.CrossRefPubMed
25.
Niu X, Xu H, Inwards CY, Li Y, Ding Y, Letson GD, Bui MM. Primary bone tumors: epidemiologic comparison of 9200 patients treated at Beijing Ji Shui Tan Hospital, Beijing, China, with 10 165 patients at Mayo Clinic, Rochester, Minnesota. Arch Pathol Lab Med. 2015;139:1149–55.CrossRefPubMed
26.
DelaGarza-Montano P, Estrada-Villasenor E, Dominguez Rubio R, Martinez-Lopez V, Avila-Luna A, Alfaro-Rodriguez A, Garciadiego-Cazares D, Carlos A, Hernandez-Perez AD, Bandala C. Epidemiological aspects of osteosarcoma, giant cell tumor and chondrosarcoma musculoskeletal tumors—experience of the National Rehabilitation Institute, Mexico City. Asian Pac J Cancer Prev. 2015;16:6451–5.CrossRefPubMed
27.
Wang CS, Lou JH, Liao JS, Ding XY, Du LJ, Lu Y, Yan L, Chen KM. Recurrence in giant cell tumour of bone: imaging features and risk factors. Radiol Med. 2013;118:456–64.CrossRefPubMed
28.
van der Heijden L, van de Sande MA, Dijkstra PD. Soft tissue extension increases the risk of local recurrence after curettage with adjuvants for giant-cell tumor of the long bones. Acta Orthop. 2012;83:401–5.CrossRefPubMedPubMedCentral
29.
van der Heijden L, Dijkstra PS, Campanacci DA, Gibbons CMH, van de Sande MA. Giant cell tumor with pathologic fracture: should we curette or resect? Clin Orthop Relat Res. 2013;471:820–9.CrossRefPubMedPubMedCentral
30.
Kostenuik PJ, Nguyen HQ, McCabe J, Warmington KS, Kurahara C, Sun N, Chen C, Li L, Cattley RC, Van G. Denosumab, a fully human monoclonal antibody to RANKL, inhibits bone resorption and increases BMD in knock-in mice that express chimeric (murine/human) RANKL. J Bone Miner Res. 2009;24:182–95.CrossRefPubMed
31.
Ueda T, Morioka H, Nishida Y, Kakunaga S, Tsuchiya H, Matsumoto Y, Asami Y, Inoue T, Yoneda T. Objective tumor response to denosumab in patients with giant cell tumor of bone: a multicenter phase II trial. Ann Oncol. 2015;26:2149–54.CrossRefPubMedPubMedCentral
32.
van der Heijden L, Dijkstra PD, van de Sande MA, Kroep JR, Nout RA, van Rijswijk CS, Bovee JV, Hogendoorn PC, Gelderblom H. The clinical approach toward giant cell tumor of bone. Oncologist. 2014;19:550–61.CrossRefPubMedPubMedCentral
33.
Rajani R, Schaefer L, Scarborough MT, Gibbs CP. Giant cell tumors of the foot and ankle bones: high recurrence rates after surgical treatment. J Foot Ankle Surg. 2015;54:1141–5.CrossRefPubMed
Metadata
Title
Surgery methods and soft tissue extension are the potential risk factors of local recurrence in giant cell tumor of bone
Authors
Dongqi Li
Jinlei Zhang
Yi Li
Junfeng Xia
Yihao Yang
Mingyan Ren
Yedan Liao
Shunling Yu
Xiaojuan Li
Yan Shen
Ya Zhang
Zuozhang Yang
Publication date
01-12-2016
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2016
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-016-0871-z

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