Comparison of En Bloc Resection and Intralesional Excision for Re‐resection of Giant Cell Tumors of the Spine

Objective Re‐resection of spinal giant cell tumors is an exceedingly difficult procedure. Moreover, the prognosis of patients with en bloc resection or intralesional excision for re‐resection has rarely been reported. This study aimed to compare the prognostic value of en bloc resection with that of...

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Main Authors: Hua Zhou, Yanchao Tang, Panpan Hu, Shuheng Zhai, Xiaoguang Liu, Zhongjun Liu, Feng Wei
Format: Article
Language:English
Published: Wiley 2024-03-01
Series:Orthopaedic Surgery
Subjects:
Online Access:https://doi.org/10.1111/os.13999
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author Hua Zhou
Yanchao Tang
Panpan Hu
Shuheng Zhai
Xiaoguang Liu
Zhongjun Liu
Feng Wei
author_facet Hua Zhou
Yanchao Tang
Panpan Hu
Shuheng Zhai
Xiaoguang Liu
Zhongjun Liu
Feng Wei
author_sort Hua Zhou
collection DOAJ
description Objective Re‐resection of spinal giant cell tumors is an exceedingly difficult procedure. Moreover, the prognosis of patients with en bloc resection or intralesional excision for re‐resection has rarely been reported. This study aimed to compare the prognostic value of en bloc resection with that of intralesional excision in patients undergoing re‐resection for giant cell tumors of the spine. Methods This retrospective analysis evaluated patients who underwent revision surgeries for relapse of giant cell tumors of the spine at our center between January 2005 and January 2021. Local progression‐free survival represents the duration between en bloc resection or intralesional excision and tumor recurrence. Neurological recovery, survival rates, local control, and complications were evaluated. The Kaplan–Meier estimator was used for survival analysis. Results A total of 22 patients (nine men and 13 women) with a mean age of 34.1 (range 19–63) years were included. Significant statistical differences were found in the local tumor recurrence rate between patients treated with en bloc resection and those treated with intralesional excision (p < 0.05). The 5‐ and 10‐year local progression‐free survival rates were both 90% in the en bloc resection group, while in the intralesional excision group, the 5‐year local progression‐free survival rate was 80% with a 10‐year rate of 45.7%. The en bloc resection group had a lower local tumor recurrence rate than that of the intralesional excision group (p < 0.05), but the former had a higher rate of complications (p = 0.015). Conclusions This study revealed a low local recurrence rate in patients who underwent en bloc resection for giant cell tumors, while the perioperative complication rate was high.
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spelling doaj.art-61a9c0e4a21a4371906f9feddedf5a4a2024-03-11T02:14:06ZengWileyOrthopaedic Surgery1757-78531757-78612024-03-0116361361910.1111/os.13999Comparison of En Bloc Resection and Intralesional Excision for Re‐resection of Giant Cell Tumors of the SpineHua Zhou0Yanchao Tang1Panpan Hu2Shuheng Zhai3Xiaoguang Liu4Zhongjun Liu5Feng Wei6Department of Orthopaedics Peking University Third Hospital Beijing ChinaDepartment of Orthopaedics Peking University Third Hospital Beijing ChinaDepartment of Orthopaedics Peking University Third Hospital Beijing ChinaDepartment of Orthopaedics Peking University Third Hospital Beijing ChinaDepartment of Orthopaedics Peking University Third Hospital Beijing ChinaDepartment of Orthopaedics Peking University Third Hospital Beijing ChinaDepartment of Orthopaedics Peking University Third Hospital Beijing ChinaObjective Re‐resection of spinal giant cell tumors is an exceedingly difficult procedure. Moreover, the prognosis of patients with en bloc resection or intralesional excision for re‐resection has rarely been reported. This study aimed to compare the prognostic value of en bloc resection with that of intralesional excision in patients undergoing re‐resection for giant cell tumors of the spine. Methods This retrospective analysis evaluated patients who underwent revision surgeries for relapse of giant cell tumors of the spine at our center between January 2005 and January 2021. Local progression‐free survival represents the duration between en bloc resection or intralesional excision and tumor recurrence. Neurological recovery, survival rates, local control, and complications were evaluated. The Kaplan–Meier estimator was used for survival analysis. Results A total of 22 patients (nine men and 13 women) with a mean age of 34.1 (range 19–63) years were included. Significant statistical differences were found in the local tumor recurrence rate between patients treated with en bloc resection and those treated with intralesional excision (p < 0.05). The 5‐ and 10‐year local progression‐free survival rates were both 90% in the en bloc resection group, while in the intralesional excision group, the 5‐year local progression‐free survival rate was 80% with a 10‐year rate of 45.7%. The en bloc resection group had a lower local tumor recurrence rate than that of the intralesional excision group (p < 0.05), but the former had a higher rate of complications (p = 0.015). Conclusions This study revealed a low local recurrence rate in patients who underwent en bloc resection for giant cell tumors, while the perioperative complication rate was high.https://doi.org/10.1111/os.13999En Bloc ResectionGiant Cell TumorIntralesional ExcisionRadiotherapyRecurrence
spellingShingle Hua Zhou
Yanchao Tang
Panpan Hu
Shuheng Zhai
Xiaoguang Liu
Zhongjun Liu
Feng Wei
Comparison of En Bloc Resection and Intralesional Excision for Re‐resection of Giant Cell Tumors of the Spine
Orthopaedic Surgery
En Bloc Resection
Giant Cell Tumor
Intralesional Excision
Radiotherapy
Recurrence
title Comparison of En Bloc Resection and Intralesional Excision for Re‐resection of Giant Cell Tumors of the Spine
title_full Comparison of En Bloc Resection and Intralesional Excision for Re‐resection of Giant Cell Tumors of the Spine
title_fullStr Comparison of En Bloc Resection and Intralesional Excision for Re‐resection of Giant Cell Tumors of the Spine
title_full_unstemmed Comparison of En Bloc Resection and Intralesional Excision for Re‐resection of Giant Cell Tumors of the Spine
title_short Comparison of En Bloc Resection and Intralesional Excision for Re‐resection of Giant Cell Tumors of the Spine
title_sort comparison of en bloc resection and intralesional excision for re resection of giant cell tumors of the spine
topic En Bloc Resection
Giant Cell Tumor
Intralesional Excision
Radiotherapy
Recurrence
url https://doi.org/10.1111/os.13999
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