Skip to main content
main-content

01.11.2010 | Symposium: Highlights of the ISOLS/MSTS 2009 Meeting | Ausgabe 11/2010

Clinical Orthopaedics and Related Research® 11/2010

Recurrence After and Complications Associated With Adjuvant Treatments for Sacral Giant Cell Tumor

Zeitschrift:
Clinical Orthopaedics and Related Research® > Ausgabe 11/2010
Autoren:
MD, PhD Pietro Ruggieri, MD Andreas F. Mavrogenis, MD Giuseppe Ussia, MD Andrea Angelini, MD, DSc Panayiotis J. Papagelopoulos, MD, PhD Mario Mercuri
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s11999-010-1448-8) contains supplementary material, which is available to authorized users.
Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.
This work was performed at the Istituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy, and the ATTIKON University Hospital, Athens University Medical School, Athens, Greece.

Abstract

Background

The best treatment of giant cell tumor of the sacrum is controversial. It is unclear whether adjuvant treatment with intralesional surgery reduces recurrences or increases morbidity.

Questions/purposes

We therefore asked whether adjuvants altered recurrence rates and complications after intralesional surgery for sacral giant cell tumors.

Methods

We retrospectively studied 31 patients with sacral giant cell tumors treated with intralesional surgery with and without adjuvants. Survival to local recurrence was evaluated using Kaplan-Meier analysis. The differences in survival to local recurrence with and without adjuvants were evaluated using multivariate Cox regression analysis. Complications were recorded from clinical records and images. The minimum followup was 36 months (median, 108 months; range, 36–276 months).

Results

Overall survival to local recurrence was 90% at 60 and 120 months. Survival to local recurrence with and without radiation was 91% and 89%, with and without embolization was 91% and 86%, and with and without local adjuvants was 88% and 92%, respectively. Adjuvants had no influence on local recurrence. Mortality was 6%: one patient died at 14 days postoperatively from a massive pulmonary embolism and another patient had radiation and died of a high-grade sarcoma. Fifteen of the 31 patients (48%) had one or more complications: eight patients (26%) had wound complications and seven patients (23%) had massive bleeding during curettage with hemodynamic instability. L5-S2 neurologic deficits decreased from 23% preoperatively to 13% postoperatively; S3-S4 deficits increased from 16% to 33%.

Conclusions

Adjuvants did not change the likelihood of local recurrence when combined with intralesional surgery but the complication rate was high.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de. Zusätzlich können Sie eine Zeitschrift Ihrer Wahl in gedruckter Form beziehen – ohne Aufpreis.

Weitere Produktempfehlungen anzeigen
Zusatzmaterial
Supplementary material 1 (DOC 105 kb)
11999_2010_1448_MOESM1_ESM.doc
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 11/2010

Clinical Orthopaedics and Related Research® 11/2010 Zur Ausgabe

Symposium: Highlights of the ISOLS/MSTS 2009 Meeting

The Classic: The Chemical Constitution of Respiration Ferment

Symposium: Highlights of the ISOLS/MSTS 2009 Meeting

Highlights of the ISOLS/MSTS 2009 Meeting: Editorial Comment

  1. Das kostenlose Testabonnement läuft nach 14 Tagen automatisch und formlos aus. Dieses Abonnement kann nur einmal getestet werden.

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Orthopädie und Unfallchirurgie und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise