Sumari Shyful Nizam, Mat Zin Nor Azman, Wan Ismail Wan Faisham, Islam Md Asiful
Department of Orthopaedics, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.
Department of Orthopaedics and Traumatology, Hospital Sungai Buloh, Sungai Buloh 47000, Selangor, Malaysia.
Cancers (Basel). 2022 Jul 8;14(14):3338. doi: 10.3390/cancers14143338.
The challenge in the surgical treatment of giant cell tumours of bone is the relatively high recurrence rate after curettage alone. The use of a local adjuvant following curettage, on the other hand, has lowered the rate of recurrence. This systematic review and meta-analysis aimed to investigate the prevalence and risk of local recurrence of giant cell tumours of the bone after cryosurgery and the subsequent complications. Web of Science, Scopus, ScienceDirect, PubMed, and Google Scholar were searched to identify articles published until 13 October 2021. A random-effects model was used to examine the pooled prevalence and risk ratio (RR) of local recurrence in patients with giant cell tumours after cryosurgery with 95% confidence intervals (CIs). This study was registered with PROSPERO (CRD42020211620). A total of 1376 articles were identified, of which 38 studies (n = 1373, 46.2% male) were included in the meta-analysis. Following cryosurgery, the pooled prevalence of local recurrence in giant cell tumours was estimated as 13.5% [95% CI: 9.3-17.8, = 63%], where European subjects exhibited the highest prevalence (24.2%). Compared to other local adjuvants. The RR of local recurrence following cryosurgery was 0.85 (95% CI: 0.63-1.17, = 15%), which was not statistically significant compared to other local adjuvants. We found 3.9% fracture, 4.0% infection, 2.1% nerve injury, and 1.5% skin necrosis as the common complications. Based on the sensitivity analyses, this study is robust and reliable. This meta-analysis estimated a low prevalence of local recurrence of giant cell tumours with low complications following cryosurgery. Thus, it can be one of the adjuvant options for treating giant cell tumours.
骨巨细胞瘤外科治疗面临的挑战是单纯刮除术后复发率相对较高。另一方面,刮除术后使用局部辅助治疗降低了复发率。本系统评价和荟萃分析旨在调查冷冻手术治疗骨巨细胞瘤后局部复发的发生率及风险以及随后的并发症。检索了Web of Science、Scopus、ScienceDirect、PubMed和谷歌学术,以识别截至2021年10月13日发表的文章。采用随机效应模型检验冷冻手术后骨巨细胞瘤患者局部复发的合并发生率及风险比(RR),并给出95%置信区间(CI)。本研究已在国际前瞻性系统评价注册库(PROSPERO)注册(注册号:CRD42020211620)。共识别出1376篇文章,其中38项研究(n = 1373,46.2%为男性)纳入荟萃分析。冷冻手术后,骨巨细胞瘤局部复发的合并发生率估计为13.5%[95%CI:9.3 - 17.8,I² = 63%],其中欧洲受试者的发生率最高(24.2%)。与其他局部辅助治疗相比,冷冻手术后局部复发的RR为0.85(95%CI:0.63 - 1.17,I² = 15%),与其他局部辅助治疗相比无统计学意义。我们发现常见并发症包括3.9%的骨折、4.0%的感染、2.1%的神经损伤和1.5%的皮肤坏死。基于敏感性分析,本研究结果稳健可靠。该荟萃分析估计冷冻手术后骨巨细胞瘤局部复发率低且并发症少。因此,它可以作为治疗骨巨细胞瘤的辅助选择之一。