Phenol as an adjuvant for local control in the treatment of giant cell tumour of the bone

被引:81
作者
Dürr, HR
Maier, M
Jansson, V
Baur, A
Refior, HJ
机构
[1] Univ Munich, Orthopad Klin & Poliklin, Klinikum Grosshadern, Dept Orthoped & Orthoped Surg, D-81366 Munich, Germany
[2] Univ Munich, Inst Radiol, Klinikum Grosshadern, D-81366 Munich, Germany
来源
EUROPEAN JOURNAL OF SURGICAL ONCOLOGY | 1999年 / 25卷 / 06期
关键词
curettage; giant cell tumour; phenol;
D O I
10.1053/ejso.1999.0716
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Aims: Intralesional treatment of giant cell tumour (GCT) of the bone may result in a high rate of local recurrence. The introduction of local adjuvant therapy, such as cementation or phenolization, has lead to a significant reduction in recurrence rates. Due to the combined use of phenol and cementation in most studies, the effect of phenol alone is described in this study. Methods: Twenty primary and nine recurrent surgical procedures in 26 patients with GCT of the bone with a median follow-up of 61 months were reviewed retrospectively. The mean age was 33.5 years (range 13.5-76.5 years). Eighteen curettages and 11 resections were performed. For the curettages, a large bone window was cut followed by high speed burring and bone graft reconstruction. In II of 18 curettages and three of 12 resections, phenol was additionally applied. Results: Four patients showed pulmonary metastasis. Three of these four cases also experienced local recurrences. Three patients died due to metastatic disease. In total, five patients developed local recurrence (17.2%); three in the first 2 years and one after 4 years. Four of 18 curettages recurred (27.2%), compared to one of 11 resections (9.1%). Only one of II patients (9.1%) treated with curettage and adjuvant phenol recurred, whereas three of seven patients (42.9%) treated with curettage alone recurred. Conclusion: Phenolization is an effective and safe local adjuvant therapy for GCT. We did not observe any significant differences in recurrence rates for curettage, phenolization and bone grafting compared to most published results using cryosurgery or cementation alone. We recommend adjuvant phenolization in the treatment of GCT of the bone alter careful curettage in applicable cases, regardless of whether additional cementation is used.
引用
收藏
页码:610 / 618
页数:9
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