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Managements of giant cell tumor within the distal radius: A retrospective study of 58 cases from a single center

BACKGROUND: Giant cell tumor of bone (GCTB) in distal radius is a benign but invasive bone tumor characterized by strong aggressive behavior and frequent recurrence. METHODS: To identify recurrence related risk factors and decide suitable surgical strategy, the potential tumor- and treatment-specifi...

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Autores principales: Zou, Changye, Lin, Tiao, Wang, Bo, Zhao, Zhiqiang, Li, Bin, Xie, Xianbiao, Huang, Gang, Yin, Junqiang, Shen, Jingnan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348933/
https://www.ncbi.nlm.nih.gov/pubmed/30705814
http://dx.doi.org/10.1016/j.jbo.2018.100211
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author Zou, Changye
Lin, Tiao
Wang, Bo
Zhao, Zhiqiang
Li, Bin
Xie, Xianbiao
Huang, Gang
Yin, Junqiang
Shen, Jingnan
author_facet Zou, Changye
Lin, Tiao
Wang, Bo
Zhao, Zhiqiang
Li, Bin
Xie, Xianbiao
Huang, Gang
Yin, Junqiang
Shen, Jingnan
author_sort Zou, Changye
collection PubMed
description BACKGROUND: Giant cell tumor of bone (GCTB) in distal radius is a benign but invasive bone tumor characterized by strong aggressive behavior and frequent recurrence. METHODS: To identify recurrence related risk factors and decide suitable surgical strategy, the potential tumor- and treatment-specific factors, post-operative oncologic and functional outcomes were collected and analyzed from 58 patients with GCTB of the distal radius at our center. RESULTS: With the numbers available, our analysis strongly indicated soft tissue extension (with vs. without, HR: 5.645, 95% CI: 1.424 to 22.377, p = 0.014) and size of GCTB (diameter ≥ 5 cm vs. 5 cm HR: 3.893, 95% CI: 1.109 to 13.659, p = 0.034) are the two independent risk factors related to local relapse. Neither surgical procedures (curettage vs. en-bloc resection) nor other factors apparently affected the recurrence, including age, tumor nature, dominant hand involvement, pathological fracture conditions or pre-operative denosumab. However, intralesional curettage group achieved much better functional scores ((VAS: 2.5 ± 0.8 vs. 3.6 ± 1.2, p = 0.011; MSTS: 20.2 ± 3.4 vs. 16.7 ± 3.8, P = 0.034; DASH 9.1 ± 3.9 vs. 16.4 ± 5.5, p = 0.030) and much less complications (non-unions, dislocations, fractures and infections) compared to resection ones. Furthermore, denosumab provided dramatic pain reduction and strong tumor suppression, facilitating curettage with local adjuvants even in GCTB with advanced status. CONCLUSIONS: Taken together, the radiographic presentations (soft-tissue extension and tumor size) are the strong prognostic predictors of local recurrence of GCTB in distal radius. In most tumors, an initial treatment with curettage remains feasible and first-choice, especially with the adjuvant denosumab.
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spelling pubmed-63489332019-01-31 Managements of giant cell tumor within the distal radius: A retrospective study of 58 cases from a single center Zou, Changye Lin, Tiao Wang, Bo Zhao, Zhiqiang Li, Bin Xie, Xianbiao Huang, Gang Yin, Junqiang Shen, Jingnan J Bone Oncol Research Article BACKGROUND: Giant cell tumor of bone (GCTB) in distal radius is a benign but invasive bone tumor characterized by strong aggressive behavior and frequent recurrence. METHODS: To identify recurrence related risk factors and decide suitable surgical strategy, the potential tumor- and treatment-specific factors, post-operative oncologic and functional outcomes were collected and analyzed from 58 patients with GCTB of the distal radius at our center. RESULTS: With the numbers available, our analysis strongly indicated soft tissue extension (with vs. without, HR: 5.645, 95% CI: 1.424 to 22.377, p = 0.014) and size of GCTB (diameter ≥ 5 cm vs. 5 cm HR: 3.893, 95% CI: 1.109 to 13.659, p = 0.034) are the two independent risk factors related to local relapse. Neither surgical procedures (curettage vs. en-bloc resection) nor other factors apparently affected the recurrence, including age, tumor nature, dominant hand involvement, pathological fracture conditions or pre-operative denosumab. However, intralesional curettage group achieved much better functional scores ((VAS: 2.5 ± 0.8 vs. 3.6 ± 1.2, p = 0.011; MSTS: 20.2 ± 3.4 vs. 16.7 ± 3.8, P = 0.034; DASH 9.1 ± 3.9 vs. 16.4 ± 5.5, p = 0.030) and much less complications (non-unions, dislocations, fractures and infections) compared to resection ones. Furthermore, denosumab provided dramatic pain reduction and strong tumor suppression, facilitating curettage with local adjuvants even in GCTB with advanced status. CONCLUSIONS: Taken together, the radiographic presentations (soft-tissue extension and tumor size) are the strong prognostic predictors of local recurrence of GCTB in distal radius. In most tumors, an initial treatment with curettage remains feasible and first-choice, especially with the adjuvant denosumab. Elsevier 2018-12-14 /pmc/articles/PMC6348933/ /pubmed/30705814 http://dx.doi.org/10.1016/j.jbo.2018.100211 Text en © 2018 Published by Elsevier GmbH. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Research Article
Zou, Changye
Lin, Tiao
Wang, Bo
Zhao, Zhiqiang
Li, Bin
Xie, Xianbiao
Huang, Gang
Yin, Junqiang
Shen, Jingnan
Managements of giant cell tumor within the distal radius: A retrospective study of 58 cases from a single center
title Managements of giant cell tumor within the distal radius: A retrospective study of 58 cases from a single center
title_full Managements of giant cell tumor within the distal radius: A retrospective study of 58 cases from a single center
title_fullStr Managements of giant cell tumor within the distal radius: A retrospective study of 58 cases from a single center
title_full_unstemmed Managements of giant cell tumor within the distal radius: A retrospective study of 58 cases from a single center
title_short Managements of giant cell tumor within the distal radius: A retrospective study of 58 cases from a single center
title_sort managements of giant cell tumor within the distal radius: a retrospective study of 58 cases from a single center
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348933/
https://www.ncbi.nlm.nih.gov/pubmed/30705814
http://dx.doi.org/10.1016/j.jbo.2018.100211
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