Vult von Steyern F, Bauer H C F, Trovik C, Kivioja A, Bergh P, Holmberg Jörgensen P, Follerås G, Rydholm A
Department of Orthopaedics, Lund University Hospital, SE-221 85 Lund, Sweden.
J Bone Joint Surg Br. 2006 Apr;88(4):531-5. doi: 10.1302/0301-620X.88B4.17407.
We retrospectively studied local recurrence of giant cell tumour in long bones following treatment with curettage and cementing in 137 patients. The median follow-up time was 60 months (3 to 166). A total of 19 patients (14%) had at least one local recurrence, the first was diagnosed at a median of 17 months (3 to 29) after treatment of the primary tumour. There were 13 patients with a total of 15 local recurrences who were successfully treated by further curettage and cementing. Two patients with a second local recurrence were consequently treated twice. At the last follow-up, at a median of 53 months (3 to 128) after the most recent operation, all patients were free from disease and had good function. We concluded that local recurrence of giant cell tumour after curettage and cementing in long bones can generally be successfully treated with further curettage and cementing, with only a minor risk of increased morbidity. This suggests that more extensive surgery for the primary tumour in an attempt to obtain wide margins is not the method of choice, since it leaves the patient with higher morbidity with no significant gain with respect to cure of the disease.
我们对137例长骨骨巨细胞瘤刮除植骨术后的局部复发情况进行了回顾性研究。中位随访时间为60个月（3至166个月）。共有19例患者（14%）至少出现1次局部复发，首次复发诊断于原发肿瘤治疗后的中位时间为17个月（3至29个月）。13例患者共出现15次局部复发，通过再次刮除植骨成功治愈。2例出现第二次局部复发的患者因此接受了两次治疗。在最近一次手术后的中位时间为53个月（3至128个月）的最后一次随访时，所有患者均无疾病且功能良好。我们得出结论，长骨骨巨细胞瘤刮除植骨术后的局部复发通常可通过再次刮除植骨成功治疗，仅存在轻微的并发症增加风险。这表明，为了获得广泛切缘而对原发肿瘤进行更广泛的手术并非首选方法，因为这会使患者的并发症更高，且在疾病治愈方面并无显著获益。
