PDF(Pubmed)
Abstract：
The giant cell tumor of bones (GCTB) is a benign bone tumor with high postoperative recurrence potential. No specific treatment protocol has been developed to date in case of tumor recurrence, and the kind of re-operative surgery depends upon the surgeon\'s preferences. The aim of this systematic review is to determine the second recurrence rate and the respective functional results of the available treatment options applied to recurrent GCTB. Medline/PubMed and Scopus were searched to identify articles published until March 2023. Twelve studies fulfilled the inclusion criteria, comprising 458 patients suffering from recurrent GCTB. The overall incidence of second recurrence was 20.5%, at a mean interval of 28.8 months after the first surgery, and it was more evident after intralesional curettage (IC) surgery than en-bloc resection (EBR) (p = 0.012). In the IC group of patients, the second recurrence rate was lower and the functional outcome was greater when polymethylmethacrylate cement (PMMAc) was used as an adjuvant instead of bone grafting (p < 0.001 for both parameters). Reconstruction of the created bone defect after EBR with a structural allograft provided a better outcome than prosthesis (p = 0.028). According to this systematic review, EBR (first choice) and IC with PMMAc (second choice) are the best treatment options for recurrent GCTB.
摘要：
骨巨细胞瘤（GCTB）是一种良性骨肿瘤，具有较高的术后复发潜力。迄今为止，在肿瘤复发的情况下，尚未开发出特定的治疗方案。再次手术的种类取决于外科医生的偏好。本系统评价的目的是确定应用于复发性GCTB的可用治疗方案的第二复发率和各自的功能结果。搜索了Medline/PubMed和Scopus，以识别直到2023年3月发表的文章。12项研究符合纳入标准，包括458例复发性GCTB患者。第二次复发的总发生率为20.5%，第一次手术后平均间隔28.8个月，病灶内刮治（IC）手术后比整块切除术（EBR）更明显（p=0.012）。在IC组患者中，使用聚甲基丙烯酸甲酯骨水泥(PMMAc)代替植骨作为佐剂时,第二复发率较低,功能结局较大(两个参数p<0.001).用结构性同种异体移植物重建EBR后产生的骨缺损比假体提供了更好的结果（p=0.028）。根据这个系统的回顾,EBR（第一选择）和IC与PMMAc（第二选择）是复发性GCTB的最佳治疗选择。
