Iliosacral Resection for Primary Bone Tumors

Beadel, G.; McLaughlin, Catherine E; Al-Jassir, Fawzi F.; Turcotte, Robert; Isler, Marc; Ferguson, Peter C.; Griffin, Anthony M.; Bell, Robert S.; Wunder, Jay S.

doi:10.1097/01.blo.0000180046.97466.bc

Cited by 68 publications

(97 citation statements)

References 19 publications

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“…Yet wide en-bloc resection was considered as overtreatment due to excessive blood loss or postoperative pelvic instability. Moreover, the neurological functional sacrifice was serious, including loss of bowel, bladder control, or sexual dysfunction 15,36,37 . Thus, SAE had been presented as an alternative treatment for unresectable or recurrent GCT after surgery.…”

Section: Disadvantages Of Surgerymentioning

confidence: 99%

“…In addition, neurological dysfunction at the expense of incontinence and sexual dysfunction could lead to psychological issues after surgery 13 . Pelvic instability is also a problem for surgery, especially for en-bloc resection, and gives rise to difficulties in reconstruction 14,15 . Moreover, surgical intervention plays an extremely limited role in those refractory and unresectable GCTB.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, neurological dysfunction at the expense of incontinence and sexual dysfunction could lead to psychological issues after surgery 13 . Pelvic instability is also a problem for surgery, especially for en-bloc resection, and gives rise to difficulties in reconstruction 14,15 . Moreover, surgical Selective arterial embolization (SAE), as a form of nonoperative management, has been proved as a viable option for the treatment of GCTB because it can reduce the tumor size and/or induce ossification.…”

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confidence: 99%

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Selective Arterial Embolization for the Treatment of Sacral and Pelvic Giant Cell Tumor: A Systematic Review

Sun

et al. 2017

Orthopaedic Surgery

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Giant cell tumor of the bone (GCTB) is a locally aggressive tumor with a certain distant metastatic rate. For sacral GCT (SGCT) and pelvic GCT (PGCT), surgery has its limitations, especially for unresectable or recurrent tumors. Selective arterial embolization (SAE) is reported to be an option for treatment in several cases, but there are few systematic reviews on the effects of SAE on SGCT and/or PGCT. Medline and Embase databases were searched for eligible English articles. Inclusion and exclusion criteria were conducted before searching. All the clinical factors were measured by SPSS software, with P-values ≤0.05 considered statistically significant. A total of 9 articles were retrieved, including 44 patients receiving SAE ranging from 1 to 10 times. During the mean follow-up period of 85.8 months, the radiographic response rate was 81.8%, with a local control and overall survival rate of 75% and 81.8%, respectively. No bowel, bladder, or sexual dysfunction was observed. Three patients developed distant metastases and finally died. Patients with primary tumors tended to have better prognosis than those with recurrence (P = 0.039). The favorable outcomes of SAE suggest that it may be an alternative treatment for SGCT and PGCT patients for whom surgery is not appropriate.Key words: Local control; Overall survival; Pelvis; Sacral giant cell tumor; Selective arterial embolization Introduction G iant cell tumor of bone (GCTB) is defined as a potential locally aggressive tumor with a distant metastatic rate of approximately 6.6% [1][2][3][4][5][6] . It occurs most in the second to fourth decades of young adults, but also can be found in patients at any other period. Morbidities between men and women are almost equal. Epiphysis and metaphysis of long bones are the most prevalent sites among the GCT occurrence sites, especially at the distal femur and proximal tibia. Sacral giant cell tumor (SGCT) is the third most common GCTB. SGCT accounts for 2%-8% of all GCTB cases, while pelvic giant cell tumors (PGCT) are less frequent [7][8][9][10][11] . Pain is the most common complaint due to the osteolytic destruction. Other clinical manifestations include pathological fracture, losing control of bladder and bowel, as well as sexual dysfunction. Pathological fracture is generally considered as a potential predictor of higher local recurrence and distant metastases rate. GCTB are usually a solid brown mass. Histologically, they contain substantial multinucleated osteoclastlike giant cells and mononuclear stromal cells. According to their radiological appearance, GCTB are classified by Campanacci et al. 5 into three grades: Stage I, latent; Stage II, active; and Stage III, aggressive.Although surgery remains the treatment of choice for local SGCT, it is limited by a high recurrence rate and heavy surgical bleeding due to the complex anatomic structures, regardless of wide excision or intralesional curretage 8,12 . In addition, neurological dysfunction at the expense of incontinence and sexual dysfunction could lead to psychol...

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Section: Disadvantages Of Surgerymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…In addition, neurological dysfunction at the expense of incontinence and sexual dysfunction could lead to psychological issues after surgery 13 . Pelvic instability is also a problem for surgery, especially for en-bloc resection, and gives rise to difficulties in reconstruction 14,15 . Moreover, surgical Selective arterial embolization (SAE), as a form of nonoperative management, has been proved as a viable option for the treatment of GCTB because it can reduce the tumor size and/or induce ossification.…”

mentioning

confidence: 99%

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Selective Arterial Embolization for the Treatment of Sacral and Pelvic Giant Cell Tumor: A Systematic Review

Sun

et al. 2017

Orthopaedic Surgery

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“…A Type I resection includes wide excision of a portion, or the entirety of, the ilium, and a Type I-S resection involves resection of a portion of the sacrum [9]. Many authors [1,2,4,11,15] have suggested different strategies to deal with the discontinuity of the pelvis. Some have forgone any reconstruction of Type I resections [2,8], leaving the pelvic ring in discontinuity.…”

Section: Introductionmentioning

confidence: 99%

“…Many authors [1,2,4,11,15] have suggested different strategies to deal with the discontinuity of the pelvis. Some have forgone any reconstruction of Type I resections [2,8], leaving the pelvic ring in discontinuity. Not reconstructing the pelvic ring, however, resigns the patient to a protracted period of bed rest for the anterior pelvis to form scar and prevent collapse and rotation of the hemipelvis.…”

Section: Introductionmentioning

confidence: 99%