Marcove R C, Weis L D, Vaghaiwalla M R, Pearson R, Huvos A G
Cancer. 1978 Mar;41(3):957-69. doi: 10.1002/1097-0142(197803)41:3<957::aid-cncr2820410325>3.0.co;2-y.
Cryosurgery combined with routine "second look" biopsy has been previously reported in our initial series of 25 cases and has been demonstrated to be a promising modality in the treatment of giant cell tumors of bone. Further refinement of this surgical technique by more careful preliminary curettage has now significantly improved the rate of local tumor control and has markedly reduced the incidence of associated complications. While the problems of infection, fracture, delayed bone healing and local tumor recurrence have not been completely eliminated, our experience with 27 additional cases shows that it has been possible to develop a highly reliable procedure for the eradication of tumor while usually preserving joint motion and avoiding arthrodesis or amputation. The 1.9% malignancy rate is much lower than the previously reported papers by Hutter and Jaffe.
冷冻手术联合常规“二次探查”活检在我们最初的25例病例系列中已有报道,并且已被证明是治疗骨巨细胞瘤的一种有前景的方式。通过更仔细的初步刮除对这种手术技术的进一步改进,现已显著提高了局部肿瘤控制率,并明显降低了相关并发症的发生率。虽然感染、骨折、骨愈合延迟和局部肿瘤复发等问题尚未完全消除,但我们对另外27例病例的经验表明,有可能开发出一种高度可靠的方法来根除肿瘤,同时通常能保留关节活动并避免关节融合术或截肢。1.9%的恶性率远低于赫特和贾菲之前报道的论文。