The impact of curettage technique on local control in giant cell tumour of bone

Мачак, Г.; Снетков, А. И.

doi:10.1007/s00264-020-04860-y

Cited by 21 publications

(19 citation statements)

References 70 publications

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“…Mechanical failures such as osteoarthritis progression and periarticular fractures have been reported to occur in 10% (2 of 21) of cases in the PMMA and periarticular bone graft group and 55% (12 of 22) of cases in the PMMA only group [31]; therefore, subchondral lesions should be filled with bone allografts and PMMA [31]. A recent systematic review reported that the use of one or two high-speed burrs, PMMA, or phenol could reduce the local recurrence rate by 50% compared to the use of simple curettage [33]. The use of a high-speed burr, PMMA, and phenol resulted in a local recurrence rate of 11% [33].…”

Section: Giant Cell Tumor Of the Extremitiesmentioning

confidence: 99%

“…A recent systematic review reported that the use of one or two high-speed burrs, PMMA, or phenol could reduce the local recurrence rate by 50% compared to the use of simple curettage [33]. The use of a high-speed burr, PMMA, and phenol resulted in a local recurrence rate of 11% [33]. Furthermore, in a study by Balke et al, the recurrence rate after re-curettage for recurrent lesions was 22% [34]; therefore, curettage seems to be a treatment option for local recurrence to achieve good functional outcomes [30].…”

Section: Giant Cell Tumor Of the Extremitiesmentioning

confidence: 99%

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Current Concepts in the Treatment of Giant Cell Tumors of Bone

Tsukamoto

Mavrogenis

Kido

et al. 2021

Cancers

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The 2020 World Health Organization classification defined giant cell tumors of bone (GCTBs) as intermediate malignant tumors. Since the mutated H3F3A was found to be a specific marker for GCTB, it has become very useful in diagnosing GCTB. Curettage is the most common treatment for GCTBs. Preoperative administration of denosumab makes curettage difficult and increases the risk of local recurrence. Curettage is recommended to achieve good functional outcomes, even for local recurrence. For pathological fractures, joints should be preserved as much as possible and curettage should be attempted. Preoperative administration of denosumab for pelvic and spinal GCTBs reduces extraosseous lesions, hardens the tumor, and facilitates en bloc resection. Nerve-sparing surgery after embolization is a possible treatment for sacral GCTBS. Denosumab therapy with or without embolization is indicated for inoperable pelvic, spinal, and sacral GCTBs. It is recommended to first observe lung metastases, then administer denosumab for growing lesions. Radiotherapy is associated with a risk of malignant transformation and should be limited to cases where surgery is impossible and denosumab, zoledronic acid, or embolization is not available. Local recurrence after 2 years or more should be indicative of malignant transformation. This review summarizes the treatment approaches for non-malignant and malignant GCTBs.

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Section: Giant Cell Tumor Of the Extremitiesmentioning

confidence: 99%

Section: Giant Cell Tumor Of the Extremitiesmentioning

confidence: 99%

Current Concepts in the Treatment of Giant Cell Tumors of Bone

Tsukamoto

Mavrogenis

Kido

et al. 2021

Cancers

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“…Based on a large number of cases, no clinicians have observed that HSB use will increase the possibility of recurrence and invasion, while the convenience to surgeons is obvious. Most researchers contend that HSB alone cannot play a definite role in the reduction of tumour cells and needs to be combined with other inactivation methods ( 44 ). Although, there is no literature regarding the effect of HSB on local bone repair, we argue that the mere removal of tissues has very little effect.…”

Section: Review and Findingsmentioning

confidence: 99%

Management of the Cavity After Removal of Giant Cell Tumor of the Bone

Wang

Tian

et al. 2021

Front. Surg.

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Purpose: To find out the most appropriate management scheme through the analysis and comparison of different inactivation methods and filling materials.Method: A systematic literature search was performed using the terms, anhydrous ethanol, phenol, hypertonic saline, cryotherapy, thermal therapy, bone reconstruction, GCTB, and etc., Selected articles were studied and summarized. The mechanism, clinical effects, and influence on bone repair of various methods are presented. Recent developments and perspectives are also demonstrated.Recent Findings: Compared to curettage alone, management of the residual cavity can effectively reduce the recurrence of giant cell tumours of bone. It is a complex and multidisciplinary process that includes three steps: local control, cavity filling, and osteogenic induction. In terms of local control, High-speed burring can enlarge the area of curettage but may cause the spread and planting of tumour tissues. Among the inactivation methods, Anhydrous ethanol, and hyperthermia therapy are relatively safe and efficient. The combination of the two may achieve a better inactivation effect. When inactivating the cavity, we need to adjust the approach according to the invasion of the tumour. Filling materials and bone repair should also be considered in management.

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“…Approximately 5% of all primary bone tumors are GCTB [ 1 ]; moreover, GCTBs commonly occur in the distal femur, proximal tibia, and distal radius [ 1 ]. GCTB have a high local recurrence rate (median, 20%) [ 2 ], 1–9% of GCTBs develop distant metastases [ 3 , 4 , 5 , 6 , 7 , 8 ], and approximately 2.4% of GCTBs develop malignant transformation (secondary malignant GCTB) [ 9 , 10 ]. The prognosis of malignant GCTB remains poor, with a reported mortality rate of 42–70% [ 11 , 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…The prognosis of malignant GCTB remains poor, with a reported mortality rate of 42–70% [ 11 , 12 , 13 , 14 ]. Curettage is the mainstay of treatment for preserving good limb function; however, it is associated with a relatively high local recurrence rate (median, 20%) [ 2 ]. En bloc resection (resection of a large bulky tumor virtually without dissection) should be considered in cases of extensive cortical destruction with extensive soft tissue involvement [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Outcome of Reoperation for Local Recurrence Following En Bloc Resection for Bone Giant Cell Tumor of the Extremity

et al. 2022

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En bloc resection is typically performed to treat giant cell tumors of bone (GCTB), particularly when curettage can be challenging owing to extensive bone cortex destruction with soft tissue extension. Few reports have addressed the clinical outcomes after reoperation for local recurrence in patients with GCTB who underwent en bloc resection. In this multicenter retrospective study, we investigated local recurrence, distant metastasis, malignant transformation, mortality, and limb function in patients treated for local recurrence following en bloc resection for GCTB. Among 205 patients who underwent en bloc resection for GCTB of the extremities between 1980 and 2021, we included 29 with local recurrence. En bloc resection was performed for large tumors with soft tissue extension, pathological fractures with joint invasion, complex fractures, and dispensable bones, such as the proximal fibula and distal ulna. Local re-recurrence, distant metastasis, malignant transformation, and mortality rates were 41.4% (12/29), 34.5% (10/29), 6.9% (2/29), and 6.9% (2/29), respectively. The median Musculoskeletal Tumor Society score was 26 (interquartile range, 23–28). The median follow-up period after surgery for local recurrence was 70.1 months (interquartile range, 40.5–123.8 months). Local recurrence following en bloc resection for GCTB could indicate an aggressive GCTB, necessitating careful follow-up.

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The impact of curettage technique on local control in giant cell tumour of bone

Cited by 21 publications

References 70 publications

Current Concepts in the Treatment of Giant Cell Tumors of Bone

Current Concepts in the Treatment of Giant Cell Tumors of Bone

Management of the Cavity After Removal of Giant Cell Tumor of the Bone

Outcome of Reoperation for Local Recurrence Following En Bloc Resection for Bone Giant Cell Tumor of the Extremity

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