Pitsilos Charalampos, Givissis Panagiotis, Papadopoulos Pericles, Chalidis Byron
2nd Orthopaedic Department, Aristotle University of Thessaloniki, 54635 Thessaloniki, Greece.
1st Orthopaedic Department, Aristotle University of Thessaloniki, 57010 Thessaloniki, Greece.
Cancers (Basel). 2023 Jun 22;15(13):3287. doi: 10.3390/cancers15133287.
The giant cell tumor of bones (GCTB) is a benign bone tumor with high postoperative recurrence potential. No specific treatment protocol has been developed to date in case of tumor recurrence, and the kind of re-operative surgery depends upon the surgeon's preferences. The aim of this systematic review is to determine the second recurrence rate and the respective functional results of the available treatment options applied to recurrent GCTB. Medline/PubMed and Scopus were searched to identify articles published until March 2023. Twelve studies fulfilled the inclusion criteria, comprising 458 patients suffering from recurrent GCTB. The overall incidence of second recurrence was 20.5%, at a mean interval of 28.8 months after the first surgery, and it was more evident after intralesional curettage (IC) surgery than en-bloc resection (EBR) ( = 0.012). In the IC group of patients, the second recurrence rate was lower and the functional outcome was greater when polymethylmethacrylate cement (PMMAc) was used as an adjuvant instead of bone grafting ( < 0.001 for both parameters). Reconstruction of the created bone defect after EBR with a structural allograft provided a better outcome than prosthesis ( = 0.028). According to this systematic review, EBR (first choice) and IC with PMMAc (second choice) are the best treatment options for recurrent GCTB.
骨巨细胞瘤（GCTB）是一种具有较高术后复发潜能的良性骨肿瘤。迄今为止，对于肿瘤复发尚无特定的治疗方案，再次手术的方式取决于外科医生的偏好。本系统评价的目的是确定复发性GCTB现有治疗方案的二次复发率及相应的功能结果。检索了Medline/PubMed和Scopus数据库，以识别截至2023年3月发表的文章。12项研究符合纳入标准，共纳入458例复发性GCTB患者。二次复发的总体发生率为20.5%，首次手术后平均间隔28.8个月，病灶内刮除术（IC）后比整块切除术（EBR）更明显（P = 0.012）。在IC组患者中，使用聚甲基丙烯酸甲酯骨水泥（PMMAc）作为辅助治疗而非植骨时，二次复发率更低，功能结局更好（两个参数P均< 0.001）。EBR后用结构性同种异体骨重建骨缺损比使用假体效果更好（P = 0.028）。根据本系统评价，EBR（首选）和IC联合PMMAc（次选）是复发性GCTB的最佳治疗选择。
