University of South Carolina School of Medicine, Columbia, SC.
Children's Hospital Los Angeles, Los Angeles, CA.
J Pediatr Orthop. 2024 Jan 1;44(1):e79-e83. doi: 10.1097/BPO.0000000000002536. Epub 2023 Oct 10.
Aneurysmal bone cysts (ABCs) are benign active tumors often requiring intralesional curettage with or without adjuvants. The primary aim of this study was to analyze whether recurrence is influenced by the use of surgical adjuvants in pediatric patients with ABCs. Secondary aims examined recurrence rates based on age, sex, and physeal contact.
A retrospective review was performed at a tertiary pediatric hospital from 2004 to 2020. Inclusion criteria consisted of patients treated surgically for histologically confirmed ABCs with a minimum of 6 months follow-up. Patients with treatment for a recurrent tumor or incomplete records were excluded. Patient demographics, location of the lesion, treatment technique, and incidence of recurrence were collected. Statistical analyses were performed using STATA.
There were 129 patients (74 males and 55 females) with a mean age of 11.5 ± 4.1 years and an average follow-up of 29.0 ± 25.4 months. The most common locations for ABCs were the femur and tibia. Of the patients, 53.5% had tumors abutting the physis, 28.7% had no physeal contact, and 17.8% had insufficient imaging to evaluate physeal contact. Surgical adjuvants (high-speed burr, coagulation, liquid nitrogen, and/or hydrogen peroxide) were used in 91 of the 129 cases (70.5%). There was no significant difference in recurrence when comparing those who received an adjuvant and those who did not (25.3% vs 23.7%, P = 1.000). Physeal contact was also not significantly associated with recurrence ( P = 0.146). Finally, patients younger than 6 years old were significantly more likely to have recurrence compared with those 6 years old or older (66.7% vs 21.7%, P = 0.007).
Our study found no association between the use of surgical adjuvants and the risk of recurrence after intralesional curettage for ABCs. Although our study did demonstrate that patients 6 years old or younger had an increased rate of recurrence, no significant association was found regarding physeal contact or sex. These data indicate that surgical adjuvant may not affect the recurrence rates of pediatric patients with ABCs.
Level III. This retrospective review compares rates of recurrence based on the choice of surgical adjuvant.
动脉瘤样骨囊肿（ABC）是一种良性活跃性肿瘤，通常需要进行病灶内刮除术，并可辅以其他辅助手段。本研究的主要目的是分析在儿童 ABC 患者中，使用手术辅助手段是否会影响复发率。次要目的是根据年龄、性别和骺板接触情况分析复发率。
对 2004 年至 2020 年在一家三级儿童医院进行的回顾性研究进行分析。纳入标准为经组织学证实的 ABC 患者，接受手术治疗，随访时间至少 6 个月。排除治疗复发性肿瘤或记录不完整的患者。收集患者的人口统计学资料、病变部位、治疗技术和复发情况。采用 STATA 进行统计学分析。
共有 129 名患者（74 名男性和 55 名女性），平均年龄为 11.5 ± 4.1 岁，平均随访时间为 29.0 ± 25.4 个月。ABC 最常见的部位是股骨和胫骨。53.5%的患者肿瘤紧邻骺板，28.7%的患者无骺板接触，17.8%的患者影像学检查不足以评估骺板接触情况。129 例患者中，91 例（70.5%）采用手术辅助手段（高速磨钻、电凝、液氮和/或过氧化氢）。比较使用和未使用辅助手段的患者，复发率无显著差异（25.3%比 23.7%，P=1.000）。骺板接触情况与复发也无显著相关性（P=0.146）。最后，年龄小于 6 岁的患者复发率明显高于 6 岁及以上患者（66.7%比 21.7%，P=0.007）。
本研究未发现病灶内刮除术辅以手术辅助手段与 ABC 复发风险之间存在关联。虽然本研究表明 6 岁及以下患者的复发率较高，但骺板接触或性别与复发无显著相关性。这些数据表明，手术辅助手段可能不会影响儿童 ABC 患者的复发率。
III 级。本回顾性研究比较了根据手术辅助手段选择的复发率。
