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Local control of long bone giant cell tumour using curettage, burring and bone grafting without adjuvant therapy

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Abstract

Giant cell tumour (GCT) is a benign, but aggressive, primary tumour of the bone. The recurrence rate after surgical treatment has been reported to be as high as 50%. Many surgical techniques have been employed in the treatment of this tumour. More aggressive interventions, such as en bloc resection and bulk allograft or prosthetic reconstruction, are generally understood to be associated with lower rates of local recurrence. However, because of lessened morbidity, intralesional techniques have come to be favoured for this condition. In addition to curettage, various adjuvant procedures and packing materials have been advocated in order to control and reconstruct long bone defects secondary to this neoplasm. We report our experience with 40 long bone GCT patients treated with curettage, burring, bone grafting and no adjuvants between 1997 and 2002. There was a local recurrence rate of 32.5%, with most recurrences noted within the first 30 months after surgery. Minor complications were found in 18% of patients. The risk of local recurrence in this study is acceptable (within the range that has been historically reported for curettage and bone grafting). In cases where more resources are available, the addition of adjuvant therapies, as noted in the recent literature, may be beneficial. The results of this study should be considered when designing multicenteric studies in the future.

Résumé

Les tumeurs à cellules géantes sont bénignes et agressives localement. Le taux de récidive après traitement chirurgical est important (50%). Beaucoup de techniques chirurgicales ont été utilisées dans le traitement de ces tumeurs. Des techniques très agressives comme la résection en bloc et une allogreffe massive ou une reconstruction prothétique ont pu être proposées avec un taux de récidive faible. Cependant du fait d’une morbidité moindre des techniques de traitement local de la tumeur ont pu être utilisées dans des conditions favorables. Après curetage, différentes procédures de reconstruction ont été réalisées. Nous rapportons notre expérience de 40 tumeurs à cellules géantes traitées par curetage, bourrage, greffes sans adjuvant particulier entre 1997 et 2002. Le taux de récidive a été de 32,5%, surtout dans les 30 premiers mois. Après l’intervention chirurgicale des complications mineures ont été retrouvées dans 18% des cas. Le risque de récidive locale, dans cette étude est acceptable.

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Authors and Affiliations

  1. San Francisco Department of Orthopaedic Surgery UCSF Comprehensive Cancer Center Orthopaedic Oncology Service, University of California, 1600 Divisadero Street, San Francisco, CA, 94115-1939, USA

    F. Malek, P. Krueger & R. J. O’Donnell

  2. Cancer Institute, Orthopaedic Oncology Service, Tehran University of Medical Sciences, Tehran, Iran

    F. Malek, Z. N. Hatmi, A. A. Malayeri & H. Faezipour

Authors
  1. F. Malek
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  2. P. Krueger
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  3. Z. N. Hatmi
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  4. A. A. Malayeri
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  5. H. Faezipour
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  6. R. J. O’Donnell
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Correspondence to F. Malek.

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Malek, F., Krueger, P., Hatmi, Z.N. et al. Local control of long bone giant cell tumour using curettage, burring and bone grafting without adjuvant therapy. International Orthopaedics (SICOT) 30, 495–498 (2006). https://doi.org/10.1007/s00264-006-0146-3

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  • DOI: https://doi.org/10.1007/s00264-006-0146-3

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