背景:动脉瘤性骨囊肿(ABC)是良性活动性肿瘤,通常需要在有或没有佐剂的情况下进行病灶内刮除。这项研究的主要目的是分析在患有ABCs的儿科患者中使用手术佐剂是否会影响复发。次要目标根据年龄检查复发率,性别,和physeal接触。
方法:对2004年至2020年在某三级儿科医院进行了回顾性研究。纳入标准包括对组织学证实的ABC进行手术治疗的患者,随访时间至少为6个月。排除接受复发性肿瘤治疗或记录不完整的患者。患者人口统计学,病变的位置,治疗技术,并收集复发率。使用STATA进行统计分析。
结果:共有129例患者(男74例,女55例),平均年龄11.5±4.1岁,平均随访29.0±25.4个月。ABCs最常见的位置是股骨和胫骨。在患者中,53.5%的肿瘤与physis相邻,28.7%没有physeal接触,17.8%的影像学检查不足以评估physeal接触。手术佐剂(高速毛刺,凝血,液氮,和/或过氧化氢)在129例中的91例(70.5%)中使用。当比较接受辅助治疗的患者和未接受辅助治疗的患者时,复发率没有显着差异(25.3%vs23.7%,P=1.000)。病菌接触也与复发无显著相关(P=0.146)。最后,与6岁或以上的患者相比,6岁以下的患者复发的可能性明显更高(66.7%vs21.7%,P=0.007)。
结论:我们的研究发现,使用手术佐剂与ABCs病灶内刮除后复发风险之间没有关联。尽管我们的研究确实表明,6岁或更小的患者复发率增加,没有发现关于physeal接触或性别的显著关联。这些数据表明手术辅助可能不会影响患有ABCs的儿科患者的复发率。
方法:三级。这项回顾性审查根据手术辅助治疗的选择比较了复发率。
BACKGROUND: Aneurysmal bone cysts (ABCs) are benign active tumors often requiring intralesional curettage with or without adjuvants. The primary aim of this study was to analyze whether recurrence is influenced by the use of surgical adjuvants in pediatric patients with ABCs. Secondary aims examined recurrence rates based on age, sex, and physeal contact.
METHODS: A retrospective review was performed at a tertiary pediatric hospital from 2004 to 2020. Inclusion criteria consisted of patients treated surgically for histologically confirmed ABCs with a minimum of 6 months follow-up. Patients with treatment for a recurrent tumor or incomplete records were excluded. Patient demographics, location of the lesion, treatment technique, and incidence of recurrence were collected. Statistical analyses were performed using STATA.
RESULTS: There were 129 patients (74 males and 55 females) with a mean age of 11.5 ± 4.1 years and an average follow-up of 29.0 ± 25.4 months. The most common locations for ABCs were the femur and tibia. Of the patients, 53.5% had tumors abutting the physis, 28.7% had no physeal contact, and 17.8% had insufficient imaging to evaluate physeal contact. Surgical adjuvants (high-speed burr, coagulation, liquid nitrogen, and/or hydrogen peroxide) were used in 91 of the 129 cases (70.5%). There was no significant difference in recurrence when comparing those who received an adjuvant and those who did not (25.3% vs 23.7%, P = 1.000). Physeal contact was also not significantly associated with recurrence ( P = 0.146). Finally, patients younger than 6 years old were significantly more likely to have recurrence compared with those 6 years old or older (66.7% vs 21.7%, P = 0.007).
CONCLUSIONS: Our study found no association between the use of surgical adjuvants and the risk of recurrence after intralesional curettage for ABCs. Although our study did demonstrate that patients 6 years old or younger had an increased rate of recurrence, no significant association was found regarding physeal contact or sex. These data indicate that surgical adjuvant may not affect the recurrence rates of pediatric patients with ABCs.
METHODS: Level III. This retrospective review compares rates of recurrence based on the choice of surgical adjuvant.