Yang Yongkun, Huang Zhen, Niu Xiaohui, Xu Hairong, Li Yuan, Liu Weifeng
Department of Orthopedic Oncology Surgery, Beijing Ji Shui Tan Hospital, Peking University, Beijing, People's Republic of China.
J Bone Oncol. 2017 Apr 6;7:23-28. doi: 10.1016/j.jbo.2017.04.001. eCollection 2017 Jun.
Pulmonary metastasis of benign giant cell tumor of bone is very rare, and its biological behavior is difficult to predict. In the present study, we analyzed the clinical characteristics of and related risk factors for pulmonary metastasis of this tumor. Forty-six patients with lung metastasis were analyzed. In total, 60.9% of the primary tumors were located around the knee joint. The Campanacci stage of all tumors was stage 3. Surgery of the primary tumor included curettage in 37 patients, resection in 8, and amputation in 1. Local recurrence after the primary surgery occurred in 34 patients. The recurrence rate, Campanacci stage, and surgical method were significant risk factors for lung metastasis. The median postoperative metastasis time in the lower limbs, upper limbs, and axial skeleton was 20.1, 7.9, and 1.4 months, respectively (p=0.010). The median metastasis time in patients with and without recurrence was 13.7 and 43.2 months, respectively (p=0.018). Eighteen patients had unilateral metastasis and 28 had bilateral metastasis. Most lesions (n=38) were located in the peripheral lung. Nineteen patients received treatment, and 12 of them underwent tumor resection. The 5-year overall survival rate was 94.4%. This study showed that local recurrence, a high Campanacci stage, and curettage were possible high-risk factors for pulmonary metastasis. The primary lesion site and local recurrence may be related to the metastasis time. The survival rate of patients with pulmonary metastasis was high.
骨良性巨细胞瘤的肺转移非常罕见,其生物学行为难以预测。在本研究中,我们分析了该肿瘤肺转移的临床特征及相关危险因素。对46例发生肺转移的患者进行了分析。原发性肿瘤中,60.9%位于膝关节周围。所有肿瘤的坎帕纳奇分期均为3期。原发性肿瘤的手术方式包括37例行刮除术、8例行切除术、1例行截肢术。34例患者在初次手术后出现局部复发。复发率、坎帕纳奇分期和手术方式是肺转移的重要危险因素。下肢、上肢和躯干骨术后发生转移的中位时间分别为20.1、7.9和1.4个月(p=0.010)。有复发和无复发患者的转移中位时间分别为13.7和43.2个月(p=0.018)。18例患者为单侧转移,28例为双侧转移。大多数病灶(n=38)位于肺周边。19例患者接受了治疗,其中12例接受了肿瘤切除术。5年总生存率为94.4%。本研究表明,局部复发、高坎帕纳奇分期和刮除术可能是肺转移的高危因素。原发灶部位和局部复发可能与转移时间有关。肺转移患者的生存率较高。