Abstract：
UNASSIGNED: The management of distal radius giant cell tumors (GCTs) remains challenging, and the optimal approach is still a matter of debate. This systematic review and meta-analysis aimed to compare the outcomes of extended curettage and wide resection, the mainstays of treatment.
UNASSIGNED: Medline (via PubMed), Cochrane Library, Web of Science, Google Scholar, ClinicalTrials.gov, and Embase databases were searched for comparative studies that assessed extended curettage with adjuvant therapy and wide resection with reconstruction in patients with GCTs of the distal radius up to April 2023. Data were collected and analyzed on rates of local recurrence, metastasis, overall complications, and functional outcomes. The Newcastle-Ottawa scale was used to appraise the risk of bias within each study.
UNASSIGNED: Fifteen studies (n = 373 patients) were included and analyzed. Patients who underwent curettage were more likely to develop recurrence (risk ratio [RR] = 3.02 [95% confidence interval; CI, 1.87-4.89], P < .01), showed fewer complications (RR = 0.32 [95% CI, 0.21-0.49], P < .01), and showed greater improvement in Visual Analog Scale and lower Disabilities of the Arm, Shoulder, and Hand scores (P < .00001) than those who underwent wide resection. No significant difference was found regarding metastasis (RR = 1.03 [95% CI, 0.38-2.78], P = .95).
UNASSIGNED: Regarding the surgical approach to GCT of the distal radius, curettage with adjuvant therapy was associated with a higher likelihood of recurrence compared with wide resection with reconstruction. Nevertheless, the curettage approach resulted in significantly lower rates of operative complications, decreased pain scores, and better functional outcomes in comparison to the resection group.
UNASSIGNED: Medline (via PubMed), Cochrane Library, Web of Science, Google Scholar, ClinicalTrials.gov, and Embase databases were searched for comparative studies that assessed extended curettage with adjuvant therapy and wide resection with reconstruction in patients with GCTs of the distal radius up to April 2023. Data were collected and analyzed on rates of local recurrence, metastasis, overall complications, and functional outcomes. The Newcastle-Ottawa scale was used to appraise the risk of bias within each study.
UNASSIGNED: Fifteen studies (n = 373 patients) were included and analyzed. Patients who underwent curettage were more likely to develop recurrence (risk ratio [RR] = 3.02 [95% confidence interval; CI, 1.87-4.89], P < .01), showed fewer complications (RR = 0.32 [95% CI, 0.21-0.49], P < .01), and showed greater improvement in Visual Analog Scale and lower Disabilities of the Arm, Shoulder, and Hand scores (P < .00001) than those who underwent wide resection. No significant difference was found regarding metastasis (RR = 1.03 [95% CI, 0.38-2.78], P = .95).
UNASSIGNED: Regarding the surgical approach to GCT of the distal radius, curettage with adjuvant therapy was associated with a higher likelihood of recurrence compared with wide resection with reconstruction. Nevertheless, the curettage approach resulted in significantly lower rates of operative complications, decreased pain scores, and better functional outcomes in comparison to the resection group.
摘要：
■桡骨远端巨细胞瘤（GCT）的治疗仍然具有挑战性，而最佳方法仍然是一个争论的问题。本系统评价和荟萃分析旨在比较长期刮宫术和广泛切除术的结果。治疗的支柱。
■Medline（通过PubMed），科克伦图书馆,WebofScience,谷歌学者，ClinicalTrials.gov,我们在Embase数据库中搜索了比较研究,这些研究评估了截至2023年4月桡骨远端GCT患者的长期刮宫联合辅助治疗和广泛切除联合重建治疗.收集数据并分析局部复发率，转移,整体并发症,和功能结果。纽卡斯尔-渥太华量表用于评估每项研究中的偏倚风险。
■纳入并分析了15项研究（n=373例患者）。进行刮宫的患者更有可能发生复发(风险比[RR]=3.02[95%置信区间;CI,1.87-4.89],P<.01),显示并发症较少(RR=0.32[95%CI，0.21-0.49]，P<.01),并显示出视觉模拟量的较大改善和手臂的较低残疾，肩膀,和手评分（P<.00001）比接受广泛切除的患者。在转移方面没有发现显着差异（RR=1.03[95％CI，0.38-2.78]，P=.95）。
■关于桡骨远端GCT的手术入路，与大范围切除重建相比，辅助治疗的刮宫复发的可能性更高。然而，刮宫法可显著降低手术并发症的发生率,疼痛评分降低，与切除组相比，功能结局更好。
■Medline（通过PubMed），科克伦图书馆,WebofScience,谷歌学者，ClinicalTrials.gov,我们在Embase数据库中搜索了比较研究,这些研究评估了截至2023年4月桡骨远端GCT患者的长期刮宫联合辅助治疗和广泛切除联合重建治疗.收集数据并分析局部复发率，转移,整体并发症,和功能结果。纽卡斯尔-渥太华量表用于评估每项研究中的偏倚风险。
■纳入并分析了15项研究（n=373例患者）。进行刮宫的患者更有可能发生复发(风险比[RR]=3.02[95%置信区间;CI,1.87-4.89],P<.01),显示并发症较少(RR=0.32[95%CI，0.21-0.49]，P<.01),并显示出视觉模拟量的较大改善和手臂的较低残疾，肩膀,和手评分（P<.00001）比接受广泛切除的患者。在转移方面没有发现显着差异（RR=1.03[95％CI，0.38-2.78]，P=.95）。
■关于桡骨远端GCT的手术入路，与大范围切除重建相比，辅助治疗的刮宫复发的可能性更高。然而，刮宫法可显著降低手术并发症的发生率,疼痛评分降低，与切除组相比，功能结局更好。
