Intralesional excision compared with en bloc resection for giant-cell tumors of bone.

Gitelis, Steven; Mallin, Bruce A.; Piasecki, Patricia; Turner, Frederick.

doi:10.2106/00004623-199311000-00009

Cited by 190 publications

(163 citation statements)

References 19 publications

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“…All of the patients who had intralesional excision eventually were disease free, and two of the six patients with recurrences maintained their distal radial joint. Many large series of intralesional excision for giant cell tumors in all locations reported recurrences between 10% and 25% [2,8,10,11,16,19,30,35,38,39]. The distal radius is somewhat unique among locations for a giant cell tumor in that it has shown one of the highest rates of recurrence with intralesional surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous authors have identified the distal radius as being particularly prone to recurrence [2,8,10,13,16,21,30,[36][37][38][39]. The suspected contributing factors for this high rate of recurrence include the anatomic geometry of the distal radius, complexity of the distal radioulnar joint, and the paucity of surrounding muscle coupled with the close proximity of critical structures such as the median nerve, radial artery, and flexor and extensor tendons that make establishing wider margins challenging.…”

Section: Introductionmentioning

confidence: 99%

“…Although the oncologic outcome with en bloc resection is reported to be excellent [2,10,16,18,27,29,36], this procedure sacrifices the joint, results in a major reconstruction, and functional outcomes are questionable. Intralesional excision preserves the joint but even if used in combination with surgical adjuvants has a reasonably high risk of local recurrence [18,28,30,36].…”

Section: Introductionmentioning

confidence: 99%

“…Intralesional excision preserves the joint but even if used in combination with surgical adjuvants has a reasonably high risk of local recurrence [18,28,30,36]. Variables reported to influence local recurrence include the Campanacci grade [2,18,22,27,30,34], pathologic fracture [27,30,40], tumor location [2,13,16,27,36,39,40], type of adjuvant used [2, 7, 10-12, 16, 17, 25, 27, 30, 32, 35, 36, 38], and treatment of a primary versus a recurrent tumor [2,27,38].…”

Section: Introductionmentioning

confidence: 99%

“…En bloc resection has been reported to result in a lower local recurrence rate compared with an intralesional excision [2,10,16,18,27,29,36].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Is Intralesional Treatment of Giant Cell Tumor of the Distal Radius Comparable to Resection With Respect to Local Control and Functional Outcome?

Wysocki

Soni

Virkus

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background A giant cell tumor is a benign locally aggressive tumor commonly seen in the distal radius with reported recurrence rates higher than tumors at other sites. The dilemma for the treating surgeon is deciding whether intralesional treatment is adequate compared with resection of the primary tumor for oncologic and functional outcomes. More information would be helpful to guide shared decision-making. Questions/purposes We asked: (1) How will validated functional scores, ROM, and strength differ between resection versus intralesional excision for a giant cell tumor of the distal radius? (2) How will recurrence rate and reoperation differ between these types of treatments? (3) What are the complications resulting in reoperation after intralesional excision and resection procedures? (4) Is there a difference in functional outcome in treating a primary versus recurrent giant cell tumor with a resection arthrodesis? Methods Between 1985 and 2008, 39 patients (39 wrists) were treated for primary giant cell tumor of the distal radius at two academic centers. Twenty patients underwent primary intralesional excision, typically in cases where bony architecture and cortical thickness were preserved, 15 underwent resection with radiocarpal arthrodesis, and four had resection with osteoarticular allograft. Resection regardless of reconstruction type was favored in cases with marked cortical expansion. A specific evaluation for purposes of the study with radiographs, ROM, grip strength, and pain and functional scores was performed at a minimum of 1 year for 21 patients (54%) and an additional 11 patients (28%) were available only by phone. We also assessed reoperations for recurrence and other complications via chart review.

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