Abstract：
OBJECTIVE: Intralesional curettage is a commonly used treatment for primary bone tumors. However, local recurrence of tumors after curettage remains a major challenge.
OBJECTIVE: (1) Is blood pressure related to local recurrence after intralesional curettage for benign or intermediate bone tumors? (2) What\'s the impact of tourniquet usage on the risk of recurrence from high blood pressure?
METHODS: This retrospective study evaluated patients receiving intralesional curettage for primary bone tumors from January 2011 to January 2015. A total of 411 patients with a minimum five-year follow-up were included for analysis. Demographic and disease-related variables were first assessed in univariable analyses for local recurrence risk. When a yielded p-value was < 0.2, variables were included in multivariable analyses to identify independent risk factors for local recurrence. Patients were then stratified by tourniquet usage (use/non-use), and risk from high blood pressure was evaluated in both subgroups.
RESULTS: At an average follow-up of 6.8 ± 1.0 years, 63 of 411 patients (15.3%) experienced local recurrence. In multivariable analyses, local recurrence was associated with age (OR, 0.96; 95% CI, 0.94-0.99; p = 0.005); tumor type; lesion size (> 5 cm: OR, 3.58; 95% CI, 1.38-9.33; p = 0.009); anatomical site (proximal femur: OR, 2.49; 95% CI, 1.21-5.15; p = 0.014; proximal humerus: OR, 3.34; 95% CI, 1.61-6.92; p = 0.001); and preoperative mean arterial pressure (> 110 mmHg: OR, 2.61; 95% CI, 1.20-5.67; P = 0.015). In subgroup analyses, after adjusting for age, tumor type, lesion size, and anatomical site, tourniquet use modified the preoperative mean arterial pressure - recurrence relationship: when tourniquet was not used, preoperative mean arterial pressure predicted local recurrence (95-110 mmHg, 4.13, 1.42-12.03, p = 0.009; > 110 mmHg, 28.06, 5.27-149.30, p < 0.001); when tourniquet was used, preoperative mean arterial pressure was not related to local recurrence (all p values > 0.05).
CONCLUSIONS: A high preoperative blood pressure was related to local recurrence after intralesional curettage for primary bone tumors in our study. Tourniquet usage and controlling blood pressure might be beneficial for reducing local recurrence in patients scheduled to receive intralesional curettage for primary bone tumor treatment.
METHODS: Level IV, hypothesis-generating study.
OBJECTIVE: (1) Is blood pressure related to local recurrence after intralesional curettage for benign or intermediate bone tumors? (2) What\'s the impact of tourniquet usage on the risk of recurrence from high blood pressure?
METHODS: This retrospective study evaluated patients receiving intralesional curettage for primary bone tumors from January 2011 to January 2015. A total of 411 patients with a minimum five-year follow-up were included for analysis. Demographic and disease-related variables were first assessed in univariable analyses for local recurrence risk. When a yielded p-value was < 0.2, variables were included in multivariable analyses to identify independent risk factors for local recurrence. Patients were then stratified by tourniquet usage (use/non-use), and risk from high blood pressure was evaluated in both subgroups.
RESULTS: At an average follow-up of 6.8 ± 1.0 years, 63 of 411 patients (15.3%) experienced local recurrence. In multivariable analyses, local recurrence was associated with age (OR, 0.96; 95% CI, 0.94-0.99; p = 0.005); tumor type; lesion size (> 5 cm: OR, 3.58; 95% CI, 1.38-9.33; p = 0.009); anatomical site (proximal femur: OR, 2.49; 95% CI, 1.21-5.15; p = 0.014; proximal humerus: OR, 3.34; 95% CI, 1.61-6.92; p = 0.001); and preoperative mean arterial pressure (> 110 mmHg: OR, 2.61; 95% CI, 1.20-5.67; P = 0.015). In subgroup analyses, after adjusting for age, tumor type, lesion size, and anatomical site, tourniquet use modified the preoperative mean arterial pressure - recurrence relationship: when tourniquet was not used, preoperative mean arterial pressure predicted local recurrence (95-110 mmHg, 4.13, 1.42-12.03, p = 0.009; > 110 mmHg, 28.06, 5.27-149.30, p < 0.001); when tourniquet was used, preoperative mean arterial pressure was not related to local recurrence (all p values > 0.05).
CONCLUSIONS: A high preoperative blood pressure was related to local recurrence after intralesional curettage for primary bone tumors in our study. Tourniquet usage and controlling blood pressure might be beneficial for reducing local recurrence in patients scheduled to receive intralesional curettage for primary bone tumor treatment.
METHODS: Level IV, hypothesis-generating study.
摘要：
目的：病灶内刮治是原发性骨肿瘤的常用治疗方法。然而,刮治后肿瘤的局部复发仍是一大挑战.
目的：（1）血压与良性或中度骨肿瘤病灶内刮除后的局部复发有关吗？（2）使用止血带对高血压复发的风险有什么影响？
方法：这项回顾性研究评估了2011年1月至2015年1月因原发性骨肿瘤而接受病灶内刮除的患者。共纳入411例至少5年随访的患者进行分析。人口统计学和疾病相关变量首先在单变量分析中评估局部复发风险。当p值<0.2时，将变量纳入多变量分析，以确定局部复发的独立危险因素。然后根据止血带的使用（使用/不使用）对患者进行分层，并对两个亚组的高血压风险进行了评估.
结果：平均随访6.8±1.0年，411例患者中有63例（15.3%）出现局部复发。在多变量分析中，局部复发与年龄相关(OR，0.96；95%CI，0.94-0.99；p=0.005）；肿瘤类型；病灶大小（>5cm：OR，3.58；95%CI，1.38-9.33；p=0.009）；解剖部位（股骨近端：OR，2.49；95%CI，1.21-5.15；p=0.014；肱骨近端：OR，3.34；95%CI，1.61-6.92；p=0.001）；和术前平均动脉压（>110mmHg：OR，2.61；95%CI，1.20-5.67；P=0.015）。在亚组分析中，在调整了年龄之后，肿瘤类型,病变大小,解剖部位，止血带使用改变术前平均动脉压-复发关系:当不使用止血带时,术前平均动脉压预测局部复发(95-110mmHg，4.13,1.42-12.03,p=0.009;>110mmHg,28.06，5.27-149.30，p<0.001）；使用止血带时，术前平均动脉压与局部复发无关(P值均>0.05).
结论：在我们的研究中，原发性骨肿瘤病灶内刮除后局部复发与术前高血压有关。使用止血带和控制血压可能有助于减少计划接受病灶内刮除治疗原发性骨肿瘤的患者的局部复发。
方法：四级，假设生成研究。
目的：（1）血压与良性或中度骨肿瘤病灶内刮除后的局部复发有关吗？（2）使用止血带对高血压复发的风险有什么影响？
方法：这项回顾性研究评估了2011年1月至2015年1月因原发性骨肿瘤而接受病灶内刮除的患者。共纳入411例至少5年随访的患者进行分析。人口统计学和疾病相关变量首先在单变量分析中评估局部复发风险。当p值<0.2时，将变量纳入多变量分析，以确定局部复发的独立危险因素。然后根据止血带的使用（使用/不使用）对患者进行分层，并对两个亚组的高血压风险进行了评估.
结果：平均随访6.8±1.0年，411例患者中有63例（15.3%）出现局部复发。在多变量分析中，局部复发与年龄相关(OR，0.96；95%CI，0.94-0.99；p=0.005）；肿瘤类型；病灶大小（>5cm：OR，3.58；95%CI，1.38-9.33；p=0.009）；解剖部位（股骨近端：OR，2.49；95%CI，1.21-5.15；p=0.014；肱骨近端：OR，3.34；95%CI，1.61-6.92；p=0.001）；和术前平均动脉压（>110mmHg：OR，2.61；95%CI，1.20-5.67；P=0.015）。在亚组分析中，在调整了年龄之后，肿瘤类型,病变大小,解剖部位，止血带使用改变术前平均动脉压-复发关系:当不使用止血带时,术前平均动脉压预测局部复发(95-110mmHg，4.13,1.42-12.03,p=0.009;>110mmHg,28.06，5.27-149.30，p<0.001）；使用止血带时，术前平均动脉压与局部复发无关(P值均>0.05).
结论：在我们的研究中，原发性骨肿瘤病灶内刮除后局部复发与术前高血压有关。使用止血带和控制血压可能有助于减少计划接受病灶内刮除治疗原发性骨肿瘤的患者的局部复发。
方法：四级，假设生成研究。
