膝关节骨巨细胞瘤30年：巴西视角
30 YEARS OF BONE GIANT CELL TUMOR IN THE KNEE: A BRAZILIAN PERSPECTIVE.
作者信息
Rodrigues Eduardo da Silva, Ghert Michelle, Antunes Bruno Pereira, Galia Carlos Roberto, Pestilho Julie Francine Cerutti Santos, Toller Eduardo Areas, de Camargo Olavo Pires, Engel Edgard Eduard, Nakagawa Suely Akiko, Guedes Alex, Becker Ricardo Gehrke
机构信息
Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
University of Maryland, College Park, MD, USA.
出版信息
Acta Ortop Bras. 2025 Jun 2;33(2):e285061. doi: 10.1590/1413-785220253302e285061. eCollection 2025.
OBJECTIVE
To analyze the evolution of patient/tumor characteristics and treatments for GCTB in the knee in Brazil over 30 years and assess changes in local recurrence rates.
METHODS
Retrospective study of 335 patients (1989-2021) from 16 Brazilian centers. Data on patient/tumor characteristics, recurrence, metastasis, and treatment trends were evaluated.
RESULTS
Campanacci grade 3 tumors, pulmonary metastasis, and local recurrence rates were 56.7%, 5.3%, and 15.8%, respectively. Recurrence was 21.4% for curettage and 9% for resection. Curettage with denosumab showed 23.8% recurrence, versus 21% for curettage alone. Overall, local recurrence decreased from 22.9% (1989-2005) to 15.1% (2006-2021), with a significant drop after en bloc resection (23% to 7.8%), while curettage-related recurrence remained stable.
CONCLUSIONS
Despite an increase in aggressive tumors, local recurrence decreased, especially after en bloc resection. These findings emphasize the challenges of managing rare diseases in emerging economies.
目的
分析巴西30年来膝关节骨巨细胞瘤患者/肿瘤特征及治疗方法的演变，并评估局部复发率的变化。
方法
对来自巴西16个中心的335例患者（1989 - 2021年）进行回顾性研究。评估患者/肿瘤特征、复发、转移及治疗趋势的数据。
结果
Campanacci 3级肿瘤、肺转移和局部复发率分别为56.7%、5.3%和15.8%。刮除术的复发率为21.4%，切除术为9%。使用地诺单抗的刮除术复发率为23.8%，单纯刮除术为21%。总体而言，局部复发率从1989 - 2005年的22.9%降至2006 - 2021年的15.1%，整块切除术后显著下降（从23%降至7.8%），而与刮除术相关的复发率保持稳定。
结论
尽管侵袭性肿瘤有所增加，但局部复发率下降，尤其是在整块切除术后。这些发现强调了新兴经济体中罕见病管理的挑战。
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