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Aggressive giant cell tumour of bone
W I Faisham1, W Zulmi, A S Halim
1Department of Orthopaedics, Musculoskeletal Oncology Unit, School of Medical Science, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia. faisham@kb.usm.my
Singapore Medical Journal
|July 26, 2006
Summary
Wide resection is recommended for aggressive giant cell tumors of bone to improve local control. Treating pulmonary metastases is essential for a better overall prognosis in these challenging bone cancer cases.
Area of Science:
- Orthopedic Oncology
- Surgical Oncology
- Bone Tumors
Background:
- Surgical management of Stage III or aggressive giant cell tumors of bone remains controversial regarding intralesional versus en-bloc resection.
- Giant cell tumors of bone (GCTB) can present aggressively, posing challenges for local control and oncological outcomes.
Purpose of the Study:
- To evaluate the effectiveness of en-bloc resection for local control in aggressive giant cell tumors of bone.
- To determine the oncological outcomes associated with wide resection for Stage III GCTB.
Main Methods:
- Retrospective review of 20 consecutive patients with Stage III giant cell tumor.
- Analysis of local control and oncological outcomes following wide resection, with exceptions for ablative surgery in cases of major neurovascular involvement.
Main Results:
- Most patients presented late (mean 24 months symptom duration); four had recurrences.
- One local recurrence occurred after wide resection, successfully treated with repeat resection and flap.
- Pulmonary metastases were present in six patients; treatment varied (thoracoscopic surgery, chemotherapy, or no chemotherapy), impacting prognosis.
Conclusions:
- Wide resection is the preferred surgical approach for aggressive giant cell tumors of bone to achieve better local control.
- Management of pulmonary metastases is critical for improving the overall prognosis in patients with advanced GCTB.
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