scholarly journals Computerised tomography features of giant cell tumour of the knee are associated with local recurrence after extended curettage

2021 ◽  
Author(s):  
Lenian Zhou ◽  
Hongyi Zhu ◽  
Shanyi Lin ◽  
Hanqiang Jin ◽  
Zhaoyuan Zhang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Local Recurrence ◽  
Giant Cell ◽  
Recurrence Rate ◽  
Prognostic Value ◽  
Giant Cell Tumour ◽  
Cell Tumour ◽  
High Recurrence Rate ◽  
Multivariate Logistic Regression ◽  
Extended Curettage

Abstract Background Extended curettage has increasingly become the preferred treatment for giant cell tumour of bone (GCTB), but the high recurrence rate after curettage poses a major challenge for orthopaedic surgeons. Computed tomography (CT) is valuable in the evaluation of GCTB. Our aim was to identify specific features of GCTB around the knee in pre-operative CT images that might have prognostic value for local recurrence. Methods We retrospectively analyzed data from 124 patients with primary GCTB around the knee who underwent extended curettage from 2010 through 2019. We collected demographic, clinical, and therapeutic data along with several CT-derived tumour characteristics. CT-derived tumor characteristics included tumour size, the distance between the tumour edge and articular surface (DTA), and destruction of posterior cortical bone (DPC). Akaike information criterion (AIC) was used to select which variables to enter into multivariate logistic regression models and to determine significant factors affecting recurrence. Results The total recurrence rate was 21.0% (26/124), and the average follow-up time was 69.5 ± 31.2 months (24–127 months). Age, DTA (< 2 mm), and DPC were significantly related to recurrence, as determined by multivariate logistic regression. The C-index of the final model was 0.79 (95% CI: 0.71 to 0.88), representing a good model for predicting recurrence. Conclusion Identifying certain features of GCTB around the knee on CT has prognostic value for patients treated with extended curettage. A three-factor model predicts tumour recurrence well after extended curettage.

The Influence of Adjuvants on Local Recurrence Rate in Giant Cell Tumour of the Bone

2010 ◽  
Vol 110 (6) ◽  
pp. 584-589 ◽  
Author(s):  
M.F. Pietschmann ◽  
R.A. Dietz ◽  
S. Utzschneider ◽  
A. Baur-Melnyk ◽  
V. Jansson ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Giant Cell ◽  
Recurrence Rate ◽  
Local Recurrence Rate ◽  
Giant Cell Tumour ◽  
Cell Tumour

scholarly journals ANALYSIS OF GIANT CELL TUMOUR OF BONES: ITS PATTERN, VARIOUS TREATMENT MODALITIES AND THEIR RESULTS

2018 ◽  
Author(s):  
Anil Pandey ◽  
Pratyush Goyal ◽  
Deepak S , Maravi ◽  
S Uikey
Keyword(s):  
Knee Joint ◽  
Giant Cell ◽  
Giant Cell Tumour ◽  
Lung Metastases ◽  
Histopathological Examination ◽  
Cell Tumour ◽  
Treatment Modalities ◽  
Tumour Mass ◽  
Intralesional Curettage ◽  
Extended Curettage

Background: Giant cell tumour is a benign aggressive tumour of bone accounting for 5% of all primary bone tumours with feature of local recurrence, potential for metastasis and malignant transformation and usually seen at the end of long bones after skeletal maturity. The incidence of lung metastases from a histologically-proven GCT ranges from 1% to 9%. The recurrence rate after intralesional curettage without adjuvant therapy is reported to be up to 50%. Extended curettage with use of adjuvents is the treatment of choice for treating the most GCT of bones. Material and method: 25 patients presented with GCTBs included.In all patients standard plain anteroposterior and lateral radiographs of the involved extremity were done.MRI of involved extremity was done in 19 cases. Diagnosis confirmed by biopsy and histopathological examination. The treatment of GCT is directed towards local control without scarifying joint function. This has been traditionally achieved by intralesional curettage with autograft reconstruction by packing the cavity of excised tumour with iliac cortico-cancellous bone.  Results: We have treated 25 patients of GCTBs. Females (15) were more commonly affected than male (10). Most common site for GCT was around the knee joint mostly in proximal tibia (6 out of 25). Average range of motion of knee joint was 60 to 112 degree and in wrist joint it was 0 to 45 degree of palmar flexion and 0 to 30 degree of dorsi flexion. Conclusion: We believe that removal of most of tumour mass by extended curettage is very essential step in preventing recurrence and achieving good functional outcome in future. Key words: giant cell tumour of bones, autograft, extended curettage

scholarly journals Giant cell tumour of the patella with local recurrence: successful management with excision, curettage and artificial bone grafting

2018 ◽  
pp. bcr-2017-221275
Author(s):  
Timothy Mark Morris ◽  
Zakareya Gamie ◽  
Kanishka Milton Ghosh ◽  
Kenneth Samora Rankin
Keyword(s):  
Local Recurrence ◽  
Giant Cell ◽  
Bone Grafting ◽  
Giant Cell Tumour ◽  
Cell Tumour ◽  
Artificial Bone ◽  
Successful Management

In-depth analysis of local recurrence of giant cell tumour of bone with soft tissue extension after intralesional curettage

2014 ◽  
Vol 119 (11) ◽  
pp. 861-870 ◽  
Author(s):  
Liang Chen ◽  
Xiao-Yi Ding ◽  
Chengs-Sheng Wang ◽  
Ming-Jue Si ◽  
Lian-Jun Du ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Local Recurrence ◽  
Giant Cell ◽  
Giant Cell Tumour ◽  
Cell Tumour ◽  
Intralesional Curettage ◽  
Soft Tissue Extension ◽  
Depth Analysis

Prognosis of local recurrence in giant cell tumour of bone: what can we do?

2017 ◽  
Vol 122 (7) ◽  
pp. 505-519 ◽  
Author(s):  
Yifeng He ◽  
Ji Zhang ◽  
Xiaoyi Ding
Keyword(s):  
Local Recurrence ◽  
Giant Cell ◽  
Giant Cell Tumour ◽  
Cell Tumour

scholarly journals Comparative Analysis of Two Surgical Treatment Options for Giant Cell Tumor of the Proximal Femur: Extended Curettage and Segmental Resection

2021 ◽  
Vol 11 ◽  
Author(s):  
Yuhao Yuan ◽  
Qing Liu ◽  
Yupeng Liu ◽  
Ziyi Wu ◽  
Wei Zhong ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Local Recurrence ◽  
Giant Cell Tumor ◽  
Giant Cell ◽  
Recurrence Rate ◽  
Proximal Femur ◽  
Cell Tumor ◽  
Evaluation Standard ◽  
Msts Score ◽  
Extended Curettage

AimAs a locally destructive intermediate bone tumor with low incidence, high recurrence rate, and difficulty in reconstruction, giant cell tumor of bone (GCTB) in the proximal femur has no unified surgical treatment standard. This study aimed to compare the differences in local recurrence, reconstruction durability, and postoperative function after treatment with either extended curettage (EC) or segmental resection (SR) for GCTB in the proximal femur so as to provide constructive suggestions for the rational selection of EC or SR operation scheme.Patients and Methods29 patients (15 men and 14 women) were included in this retrospective study, with a mean age of 32.1 years. According to the division method of proximal femur of International Society Of Limb Salvage (ISOLS), there was 1 case in the H1 area, 17 cases in the H2 area, 10 cases in the H1+H2 area, and 1 case in the H1+H2+H3 area. Among them were 11 cases of Campanacci grade II GCTB, 18 cases of Campanacci grade III GCTB, and 7 cases with pathological fractures. All patients underwent either EC or SR surgery. The Musculoskeletal Tumor Society (MSTS) score was used for patient evaluation. The operation effectiveness was analyzed according to the Mankin evaluation standard. Regular follow-up was performed to evaluate the recurrence rate, limb function, and long-term complications of the two surgical methods.ResultsAll patients were followed up for a mean of 60.4 months. Local recurrence occurred in one of 19 patients treated with EC (5.3%) and one of 10 patients treated with SR (10%). The MSTS score of lower limb function in patients in the EC group was better compared to patients in the SR group (P = 0.002). Complications occurred in 2 cases (10.5%) and 5 cases (50%) in the EC group (osteoarthritis, osteonecrosis) and SR group (joint stiffness, infection, prosthesis loosening), respectively, with significant differences between the two groups (P = 0.03). The operation effectiveness was analyzed according to the Mankin evaluation standard. The EC group showed an optimal rate of 94.7% (18/19) as opposed to 80% (8/10) in the SR group.ConclusionsFor GCTB in the proximal femur, when the tumor does not extensively involves the surrounding soft tissues, the articular surface was not damaged, and there is no pathological fracture with apparent displacement, EC surgery should be fully considered.

scholarly journals Current status of bone cementing and bone grafting for giant cell tumour of bone: a systemic review

2019 ◽  
Vol 101 (2) ◽  
pp. 79-85 ◽  
Author(s):  
R Vaishya ◽  
A Pokhrel ◽  
AK Agarwal ◽  
V Vijay
Keyword(s):  
Bone Graft ◽  
Bone Cement ◽  
Giant Cell ◽  
Recurrence Rate ◽  
Bone Grafting ◽  
Giant Cell Tumour ◽  
Cell Tumour ◽  
Systemic Review ◽  
Current Status ◽  
Intralesional Curettage

Introduction Extended intralesional curettage, together with bone grafting/cementing, is considered as a surgical treatment option for giant cell tumour of the bone. This study aimed to discover the efficacy and recurrence rate with the use of bone cement in giant cell tumour and to compare it with that of bone grafting. Material and methods The present systemic review is derived from the publications in the past 10 years (2009–2018). A literature search was performed via PubMed, using suitable keywords and Boolean operators database (‘Giant cell tumor,’ ‘osteoclastoma,’ ‘bone,’ ‘bone cement,’ ‘bone graft’ and ‘curettage’). A detailed statistical analysis of the data derived from the published literature was done. Results The patients who underwent bone graft only exhibited significantly higher recurrence rates than those treated with polymethyl methacrylate only (risk ratio 1.90; 95% confidence interval 1.14, 3.16; overall effect Z = 2.488; P-value 0.012). The observational analysis was done in rest of the seven studies; three studies showed no recurrence rate. Only one study reported the highest recurrence rate of 42% and the remaining six had an overall recurrence rate of 20.4%. Conclusion The use of bone cement was associated with a statistically significantly lower recurrence rate than bone grafting in giant cell tumour of bones. We therefore recommend the use of bone cement with extensive intralesional curettage. Adjuvant therapy like electrocautery, phenol irrigation and the use of intravenous denosumab or bisphosphonates may help in decreasing the incidence of recurrence in giant cell tumour of bone.

The Effect of Cellular Proliferative Activity on Recurrence and Local Tumour Extent of Localized Giant Cell Tumour of Tendon Sheath

2004 ◽  
Vol 29 (6) ◽  
pp. 604-607 ◽  
Author(s):  
Y. KITAGAWA ◽  
H. ITO ◽  
M. YOKOYAMA ◽  
T. SAWAIZUMI ◽  
S. MAEDA
Keyword(s):  
Giant Cell ◽  
Recurrence Rate ◽  
Proliferative Activity ◽  
Giant Cell Tumour ◽  
Tendon Sheath ◽  
Cell Tumour ◽  
Significant Difference ◽  
Staining Index ◽  
Tumour Extent ◽  
Mib 1

This study investigates whether the proliferative activity of giant cell tumour of tendon sheath is related to its recurrence rate and local aggressiveness. The clinicopathological and immunohistochemical features of 30 localized giant cell tumours of tendon sheath were studied and the influence of the MIB-1 staining index on recurrence, tumour extent around the phalanx and involvement of the bone were evaluated. No significant difference in the MIB-1 staining index was found between the lesions which recurred and those which did not. Also there was no significant association between local aggressiveness and the MIB-1 staining index. These results suggest that the proliferative activity of localized giant cell tumour of tendon sheath is not related to its high recurrence rate and local aggressiveness.

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