The reconstruction after en-bloc resection of giant cell tumors at the distal radius: A systematic review and meta-analysis of the ulnar transposition reconstruction technique

2020 ◽  
Vol 34 ◽  
pp. 147-153
Author(s):  
Thanapon Chobpenthai ◽  
Pichaya Thanindratarn ◽  
Termphong Phorkhar ◽  
Thammasin Ingviya
Keyword(s):  
Systematic Review ◽  
Giant Cell ◽  
Distal Radius ◽  
Meta Analysis ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Reconstruction Technique ◽  
Giant Cell Tumors ◽  
En Bloc

scholarly journals A Systematic Review and Meta-Analysis of En-Bloc vs Intralesional Resection for Giant Cell Tumor of Bone of the Distal Radius

2013 ◽  
Vol 7 (1) ◽  
pp. 103-108 ◽  
Author(s):  
Theresa J.C Pazionis ◽  
Hussain Alradwan ◽  
Benjamin M Deheshi ◽  
Robert Turcotte ◽  
Forough Farrokhyar ◽  
...  
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Distal Radius ◽  
Wrist Joint ◽  
Meta Analysis ◽  
En Bloc Resection ◽  
Cell Tumor ◽  
En Bloc ◽  
Intralesional Curettage ◽  
Functional Benefit

Introduction: Surgical management of Giant Cell Tumor of Bone of the distal radius (GCTDR) remains controversial due to risk of local recurrence (LR) offset by functional limitations which result from en-bloc resection. This study aims to determine the oncologic and functional outcomes of wide excision (WE) vs intralesional curettage (IC) of GCTDR. Methods: A complete search of the applicable literature was done. Included studies reported on patients from the same cohort who were surgically treated for GCTDR with WE or IC. Two reviewers independently assessed all papers. The primary outcome measure was LR. Results: One-hundred-forty-one patients from six studies were included: 60 treated with WE, and 81 with IC. Five WE patients (8%) suffered LR whereas 25 IC patients (31%) did. The odds of LR were three times less in the WE group vs the IC group. MSTS1993 scores, where available, were on average 'good' with WE and 'excellent' with IC. Conclusions: Within statistical limitations the data support an attempt, where feasible, at wrist joint preservation and superior function with IC. Intralesional curettage is reasonable when the functional benefit outweighs the risk of recurrence as is the case in many cases of GCT of the distal radius.

scholarly journals Giant Cell Tumor of Bone: 6 Years Institutional Retrospective Review

2020 ◽  
Vol 6 (01) ◽  
pp. 12-17
Author(s):  
Nadeem Ali ◽  
Dar Ghulam Nabi ◽  
Azad Ahmad Shah ◽  
Altaf Ahmad Kawoosa ◽  
Mohammad Umar Mumtaz
Keyword(s):  
Giant Cell ◽  
Distal Radius ◽  
Proximal Tibia ◽  
Surgical Intervention ◽  
En Bloc Resection ◽  
Joint Involvement ◽  
Common Site ◽  
Giant Cell Tumors ◽  
En Bloc ◽  
Intralesional Curettage

Abstract Introduction Surgery is the cornerstone for the management of giant cell tumors (GCTs). There are no definite guidelines for the management. The purpose of this series was to study the patient demography and results of the surgical intervention for skeletal GCTs in our population. Materials and Methods All the histologically diagnosed cases of GCT of bone from year 2012 to 2018 were retrospectively analyzed for patient demographics, site, and grade of the lesion, type of biopsy taken (if any), nature of surgical intervention, and final outcome with respect to complications. Results Seventeen cases of skeletal GCT were diagnosed on histopathology. The mean age at presentation was 31.5 ± 10.9 years with females affected 1.4 times more. Proximal tibia was the most common site (29.4%) followed by distal radius and distal femur in that order. About 58.8% of the lesions were of Campanacci grade 2 and remaining were grade 3 lesions. Ten patients had extended curettage, five had en bloc resection, and one had amputation as the primary treatment. Twenty percent patients (n = 3) had local recurrence of the pathology and one patient developed distant recurrence (lung metastasis). Conclusion Proximal tibia followed by distal radius was the most common site of GCT in our population. The tumor behavior and recurrence cannot be predicted with any grading system. The goal should be salvage of the joint by intralesional curettage, with resection reserved for distal radius GCTs, cases with extensive soft tissue extension or those with destruction of the articular cartilage and joint involvement.

scholarly journals Underwater vs conventional endoscopic mucosal resection in the management of colorectal polyps: a systematic review and meta-analysis

2020 ◽  
Vol 08 (10) ◽  
pp. E1264-E1272
Author(s):  
Faisal Kamal ◽  
Muhammad Ali Khan ◽  
Wade Lee-Smith ◽  
Zubair Khan ◽  
Sachit Sharma ◽  
...  
Keyword(s):  
Systematic Review ◽  
Endoscopic Mucosal Resection ◽  
Meta Analysis ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Colorectal Polyps ◽  
Complete Resection ◽  
En Bloc ◽  
Mucosal Resection ◽  
Significant Difference

Abstract Background Recently, underwater endoscopic mucosal resection (UEMR) has shown promising results in the management of colorectal polyps. Some studies have shown better outcomes compared to conventional endoscopic mucosal resection (EMR). We conducted this systematic review and meta-analysis to compare UEMR and EMR in the management of colorectal polyps. Methods We searched several databases from inception to November 2019 to identify studies comparing UEMR and EMR. Outcomes assessed included rates of en bloc resection, complete macroscopic resection, recurrent/residual polyps on follow-up colonoscopy, complete resection confirmed by histology and adverse events. Pooled risk ratios (RR) with 95 % confidence interval were calculated using a fixed effect model. Heterogeneity was assessed by I2 statistic. Funnel plots and Egger’s test were used to assess publication bias. We used the Newcastle-Ottawa scale (NOS) for assessment of quality of observational studies, and the Cochrane tool for assessing risk of bias for RCTs Results Seven studies with 1291 patients were included; two were randomized controlled trials and five were observational. UEMR demonstrated statistically significantly better efficacy in rates of en bloc resection, pooled RR 1.16 (1.08, 1.26), complete macroscopic resection, pooled RR 1.28 (1.18, 1.39), recurrent/residual polyps; pooled RR 0.26 (0.12, 0.56) and complete resection confirmed by histology; pooled RR 0.75 (0.57, 0.98). There was no significant difference in adverse events (AEs); pooled RR 0.68 (0.44, 1.05). Conclusions This meta-analysis found statistically significantly better rates of en bloc resection, complete macroscopic resection, and lower risk of recurrent/residual polyps with UEMR compared to EMR. We found no significant difference in AEs between the two techniques.

Vascularized Iliac Bone Lining in Downgraded Treatment of Campanacci Grade III Giant Cell Tumor of the Distal Radius

2018 ◽  
Vol 23 (02) ◽  
pp. 255-258
Author(s):  
Kazufumi Sano ◽  
Kazumasa Kimura ◽  
Satoru Ozeki
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Distal Radius ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Cell Tumor ◽  
Iliac Bone ◽  
En Bloc ◽  
Intralesional Curettage ◽  
Grade Iii

It is commonly accepted that wide en bloc resection followed by reconstruction is essential in progressive lesions (Campanacci grade III) for local control of possible recurrence. However, specific grade III can be downgraded and treated with intralesional curettage to preserve better wrist function, without increasing the recurrency rates. In this report, Grade III giant cell tumor of the distal radius was successfully treated using vascularized osseous graft from the inner lip of the iliac bone in addition to downgrading strategy.

scholarly journals Giant Cell Tumor of Distal Radius: En Bloc Resection and Partial Wrist Arthrodesis Using Non-Vascularized Fibular Autograft

2017 ◽  
Vol 4 (2) ◽  
Author(s):  
Davod Jafari ◽  
Hooman Shariatzadeh ◽  
Mohammad Ali Okhovatpour ◽  
Mehran Razavipour ◽  
Farshad Safdari
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Distal Radius ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Cell Tumor ◽  
En Bloc ◽  
Wrist Arthrodesis ◽  
Fibular Autograft

scholarly journals THE USE OF DENOSUMAB IN GIANT CELL TUMORS IN THE SACRUM

2020 ◽  
Vol 19 (2) ◽  
pp. 151-153
Author(s):  
PEDRO LUIS BAZÁN ◽  
RENATA DI FALCO ◽  
ALVARO ENRIQUE BORRI ◽  
MARTÍN MEDINA ◽  
NICOLÁS MAXIMILIANO CICCIOLI ◽  
...  
Keyword(s):  
Giant Cell ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Weekly Dose ◽  
Giant Cell Tumors ◽  
En Bloc ◽  
Level Of Evidence ◽  
Primary Tumors ◽  
Advanced Stages ◽  
Treatment Surgery

ABSTRACT Giant Cell Tumor (GCT), a benign tumor with local aggression, corresponds to 5% of primary tumors. Fifteen percent of these are located in the sacrum. En bloc resection is an effective treatment, but when it cannot be performed, Denosumab may be indicated as an alternative treatment. The objectives of this work are: to justify the indication; determine the best dose and time of use; and recognize the need for post-treatment surgery. Methods A systematic search of clinical trials. Twenty-five articles were selected, ten of which met the inclusion criteria. The use of Denosumab is justified in advanced stages, with a dose of 120 mg administered subcutaneously, every 7 days in the first month and then maintained every 4 weeks, for 2.5 to 13 months. Adverse events are mild and can be observed in 84% of patients. With Denosumab, surgery may be less aggressive or even unnecessary. The bibliography justifies the indication of Denosumab in advanced stages of GCT, with a dose of 120 mg administered subcutaneously; there is no consensus as to the maintenance dose, which is a weekly dose in the first month and then every four weeks for 2.5 to 13 months. Complications are frequent but mild. Level of evidence III; Systematic review.

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