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巨大细胞瘤合并病理性骨折时广泛切除与刮除术的比较?一项系统评价和荟萃分析。

Wide resection versus curettage in giant cell tumor with pathological fracture? A systematic review and meta-analysis.

作者信息

Salunke Abhijeet Ashok, Pathak Subodh, Shah Jaymin, Pandit Jyotindra, Naneria Vinod

机构信息

Gujarat Cancer Research Institute, Ahmedabad, Gujarat, India.

Pramukswami Medical College, Karamsad, Gujarat, India.

出版信息

J Clin Orthop Trauma. 2018 Mar;9(Suppl 1):S15-S18. doi: 10.1016/j.jcot.2017.07.007. Epub 2017 Jul 15.

Abstract

INTRODUCTION

Currently there is no consensus if wide resection and curettage in giant cell tumor have effect on local recurrence rate in the presence of a pathological fracture.

MATERIAL AND METHOD

We conducted a comprehensive review and meta-analysis of papers which reported outcomes in patients of giant cell tumor with and without a pathological fracture. The odds ratio (OR) of local recurrence between wide resection and curettage group in giant cell tumor with pathological fracture was calculated.

RESULTS

05 eligible papers were selected for final analysis. This included patients, of whom (18.0%) had a pathological fracture. The pooled OR for local recurrence between patients of pathological fracture treated with wide resection and curettage was 0.298% (95% Confidence interval (CI) 0.0669-1.329, p = 0.97).

CONCLUSION

Wide resection and curettage in patients of giant cell tumor with pathological fracture has difference in local recurrence rates. However the presence of a pathological fracture should no be only influential factor in the decision making to perform wide resection or curettage. A proper planning and judicious approach is required in giant cell tumor with pathological fracture for deciding the appropriate treatment method.

摘要

引言

目前,对于存在病理性骨折的骨巨细胞瘤患者,广泛切除和刮除术对局部复发率是否有影响尚无共识。

材料与方法

我们对报告了有或没有病理性骨折的骨巨细胞瘤患者结局的论文进行了全面综述和荟萃分析。计算了病理性骨折的骨巨细胞瘤患者中广泛切除组和刮除组之间局部复发的比值比(OR)。

结果

选择了5篇符合条件的论文进行最终分析。这包括一些患者,其中(18.0%)有病理性骨折。病理性骨折患者接受广泛切除和刮除术后局部复发的合并OR为0.298%(95%置信区间(CI)0.0669 - 1.329, p = 0.97)。

结论

存在病理性骨折的骨巨细胞瘤患者,广泛切除和刮除术在局部复发率方面存在差异。然而,病理性骨折的存在不应是决定进行广泛切除或刮除术的唯一影响因素。对于存在病理性骨折的骨巨细胞瘤,需要进行适当规划并采取明智的方法来决定合适的治疗方法。

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Giant cell tumor of bone: Is curettage the answer?骨巨细胞瘤:刮除术是解决办法吗?
Indian J Orthop. 2007 Apr;41(2):109-14. doi: 10.4103/0019-5413.32040.
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Giant cell tumor of bone: risk factors for recurrence.骨巨细胞瘤:复发的危险因素。
Clin Orthop Relat Res. 2011 Feb;469(2):591-9. doi: 10.1007/s11999-010-1501-7. Epub 2010 Aug 13.
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Giant cell tumor of bone: treatment and outcome of 214 cases.骨巨细胞瘤:214例患者的治疗与预后
J Cancer Res Clin Oncol. 2008 Sep;134(9):969-78. doi: 10.1007/s00432-008-0370-x. Epub 2008 Mar 6.

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