| Objective By retrospectively analyzing the two surgical methods of curettage and segmental resection for giant cell tumor of bone in the extremities,we evaluated the surgical effect,analyzed the related risk factors affecting recurrence,and discussed the choice of surgical methods,so as to provide certain reference for the treatment of giant cell tumor of bone in the extremities.Methods The clinical data of the patients who met the inclusion criteria and were clinically,radiologically and pathologically diagnosed as Giant Cell Tumor(GCT)on April 1,2012 solstice and February 1,2019 in the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed.According to the different surgical methods,the patients were divided into the lesion curette group and the tumor segment resection group.Gender,age of onset,site of onset,preoperative Campanacci imaging stage,percentage of bone cross section involvement,pathological fracture and aneurysmal bone cyst were recorded in each group.Preoperative and postoperative Enneking scores,complications,recurrence,distant metastasis and malignant changes were recorded in each group.Result A total of 82 patients met the inclusion criteria and were followed up for an average of 57.91±26.71 months.There were as many as 47 patients(57.31%)around the knee joints,such as the distal femur and the proximal tibia.There were no significant differences in gender,age distribution,pathological fracture,aneurysmal bone cyst,and Campanacci stage between the two groups(P>0.05),but there were differences in the incidence site and the percentage of bone cross section involvement(P<0.05),the proportion of the lesion curettage group around the knee joint was higher than that of the tumor segment resection group(P<0.05),the percentage of bone cross section involvement in tumor resection group was higher than that in tumor curettage group(P<0.05).There was no significant correlation between the site of disease and the percentage of bone cross section involvement and the recurrence in the two groups(P>0.05).At 1,2and 5 years postoperatively,there was no significant difference in the correlation between recurrence and non-recurrence in the site of disease,pathological fracture,aneurysmal bone cyst,and Campanacci stage(P>0.05),5 years after operation,11 cases of recurrence in the lesion curettage group and 1 case in the tumor segment resection group,the difference was statistically significant(P<0.05).Preoperative Enneking score difference between the two groups was not statistically significant(P>0.05),6 months after surgery and at the last follow-up,the Enneking score of the lesion curette group was significantly higher than that of the tumor segment resection group(P<0.05).The postoperative complications in the lesion curettage group were significantly less than those in the tumor segment resection group(P<0.05).Conclusion Giant cell tumor of bone is more common in proximal tibia and distal femur.5 years after surgery,tumor recurrence was related to surgical method,but not related to tumor location,pathological fracture,aneurysmal bone cyst,Campanacci stage and percentage of bone cross section involvement.Segment resection can effectively reduce the recurrence rate of GCT,but postoperative limb function is poor and complications are more. |
