AI Article Synopsis
- The study aimed to analyze factors that contribute to the recurrence of giant cell tumors (GCTs) specifically located in the upper extremity, as those in the distal radius are considered more aggressive.
- Researchers reviewed the cases of 82 patients who underwent various surgical treatments, including wide resection and intralesional resection, and found that the recurrence rate was significantly higher (48%) for intralesional resection compared to wide resection or amputation (12%).
- The analysis determined that the type of surgery, particularly intralesional resection, was the strongest predictor of recurrence, with the location of the tumor in the distal radius also playing a role but to a lesser extent.
Article Abstract
Purpose: Giant cell tumors (GCT) of the distal radius are thought to be more aggressive than in other locations. Therefore, the aim of this study was to investigate factors associated with recurrence of GCTs in the upper extremity.
Methods: We retrospectively identified 82 patients who underwent primary surgical treatment for an upper extremity GCT. Tumors were located in the radius (n = 47), humerus (n = 17), ulna (n = 9), and hand (n = 9). Treatment consisted of either wide resection or amputation or intralesional resection with or without adjuvants. A multivariable logistic regression was performed including tumor grade, type of surgery, and tumor location, from which the percentage of contribution to the model of each variable was calculated.
Results: The recurrence rate after intralesional resection was 48%; after wide resection or amputation, it was 12%. Two patients developed a pulmonary metastasis (2.4%). In multivariable analysis, intralesional resection was independently associated with recurrence. Intralesional resection had a 77% contribution to predict recurrence and the distal radius location had a 16% contribution in the predictive model.
Conclusions: As expected, intralesional resection was the strongest independent predictor of recurrence after surgical treatment for GCT. The distal radius location contributed to the prediction of giant cell tumor recurrence to a lesser extent.
Type Of Study/level Of Evidence: Prognostic IV.
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| http://dx.doi.org/10.1016/j.jhsa.2020.04.020 | DOI Listing |
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