Tumeur à cellules géantes de la main

Which Treatment is the Best for Giant Cell Tumors of the Distal Radius? A Meta-analysis

“…Furthermore, in four studies that directly compared intralesional excision and en bloc resection [16,18,37,46], the pooled RR for tumor recurrence was 2.8 (95% CI, 1.17-6.71; p = 0.02; homogeneity I 2 , 0%), suggesting that intralesional excision was associated with a higher rate of recurrence (Fig. 2).…”

“…After application of these criteria, two reviewers (YPL, BHS) independently selected relevant studies, and discussed any discrepancies to reach a consensus. The reviewers selected a total of six studies, all of which were cohort studies published in English or Turkish between 1993 and 2010 (Table 1) [8,16,18,37,46,51]. Moreover, none of these studies included Level I or II evidence, primarily because in musculoskeletal oncologic surgical trials, patients have differences in incision length and tumor size and cannot be randomly divided into two groups.…”

“…Major complications were reported in five studies [8,18,37,46,51] for 49 patients in the curettage group versus 44 patients in the en bloc resection group. These major complications included: nonunion at the graft-radius junction, fracture of graft, skin necrosis, death, fragmentation with carpal collapse, and subluxation or arthrosis which impaired joint function.…”

“…For example, although they typically are considered benign, some are aggressive and metastasize to the lungs. GCTs typically affect young adults between the ages of 20 and 40 years [16,37,50], and occur somewhat more commonly in women [2,4,7,16,28]. GCTs have occurred in the distal radius in approximately 10% of cases (range, 8%-13%) [7,16,19,28,38,40], whereas more common sites have included the distal femur and proximal tibia.…”

“…After curettage, various filling materials have been used, including autografts [8,16,38], polymethylmethacrylate (PMMA) [16,18,37,38,46,51], calcium phosphate [31], or no packing [19]. Furthermore, numerous authors have suggested PMMA extended the effective curettage area owing to toxicity mediated by the PMMA monomer and the exothermic reaction produced by curing polymer [5,30,32,44].…”