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Giant cell tumors of the sacrum--a nationwide study on midterm results in 26 patients after intralesional excision.

AbstractPURPOSE:
Evaluation of recurrences, complications and function at mid-term follow-up after curettage for sacral giant cell tumor (GCT).
METHODS:
We retrospectively studied all 26 patients treated for sacral GCT in the Netherlands (from 1990 to 2010). Median follow-up was 98 (6-229) months. All patients underwent intralesional excision, 21 with local adjuvants, 5 radiotherapy, 3 IFN-α, 1 bisphosphonates. Functional outcome was assessed using Musculoskeletal Tumor Society (MSTS) score. Statistics were performed with Kaplan-Meier, Cox regression, log rank and Mann-Whitney U.
RESULTS:
Recurrence rate was 14/26 after median 13 (3-139) months and was highest after isolated curettage (4/5). Soft tissue masses >10 cm increased recurrence risk (HR = 3.3, 95 % CI = 0.81-13, p = 0.09). Complications were reported in 12/26 patients. MSTS was superior in patients without complications (27 vs. 21; p = 0.024).
CONCLUSION:
Recurrence rate for sacral GCT was highest after isolated curettage, indicating that (local) adjuvant treatment is desired to obtain immediate local control. Complications were common and impaired function.
AuthorsL van der Heijden, M A J van de Sande, I C M van der Geest, H W B Schreuder, B J van Royen, P C Jutte, J A M Bramer, F C Öner, A P van Noort-Suijdendorp, H M Kroon, P D S Dijkstra
JournalEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (Eur Spine J) Vol. 23 Issue 9 Pg. 1949-62 (Sep 2014) ISSN: 1432-0932 [Electronic] Germany
PMID24614982 (Publication Type: Journal Article)
Chemical References
  • Bone Density Conservation Agents
  • Diphosphonates
Topics
  • Adolescent
  • Adult
  • Aged
  • Bone Density Conservation Agents (therapeutic use)
  • Bone Neoplasms (mortality, surgery, therapy)
  • Chemoradiotherapy, Adjuvant (methods)
  • Curettage
  • Diphosphonates (therapeutic use)
  • Female
  • Follow-Up Studies
  • Giant Cell Tumor of Bone (mortality, surgery, therapy)
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Netherlands
  • Postoperative Complications (mortality)
  • Retrospective Studies
  • Risk Factors
  • Sacrum (surgery)
  • Treatment Outcome
  • Young Adult

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