Authors: Frank M Klenke Doris E Wenger Carrie Y Inwards Peter S Rose Franklin H Sim
Publish Date: 2010/09/16
Volume: 469, Issue: 4, Pages: 1181-1187
Abstract
Treatment of giant cell tumor of bone GCT often is complicated by local recurrence Intralesional curettage is the standard of care for primary GCTs However there is controversy whether intralesional curettage should be preferred over wide resection in recurrent GCTsWe retrospectively reviewed the medical records of 46 patients with recurrent GCTs of long bones treated with wide resection or intralesional curettage and compared these cohorts Recurrence rates risk factors for recurrence and the development of pulmonary metastases were determined The minimum followup was 37 months mean 134 months range 37–337 monthsThe rate of rerecurrence after wide resection was 6 Intralesional curettage showed an overall rerecurrence rate of 32 Implantation of polymethylmethacrylate PMMA instead of bone grafting was associated with a lower risk of subsequent recurrence in intralesional procedures 14 versus 50 Extracompartmental disease did not increase the risk of rerecurrence Pulmonary metastases occurred in seven patients and appeared independent of the surgical treatment modality chosenIntralesional curettage with methylmethacrylate for recurrent GCT provided equivalent tumor control compared with resection in this retrospective study If joint salvage is possible we advocate this treatment over resection in recurrent GCTs to preserve the native joint articulation
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