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Aneurysmal bone cysts: A UK wide tumor center experience
Luckshman Bavan1, Nicholas Eastley2, Jonathan Stevenson2,3
1Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Journal of Surgical Oncology
|November 15, 2023
Summary
Younger patients and those undergoing extensive surgical curettage face higher recurrence risks for aneurysmal bone cysts. Limited initial curettage during biopsy may lead to successful healing, reducing the need for further treatment.
Area of Science:
- Orthopedic Surgery
- Pediatric Oncology
- Radiology
Background:
- Aneurysmal bone cysts (ABCs) are benign, expansile, osteolytic bone lesions.
- Extra-spinal ABCs present unique management challenges.
- Identifying risk factors for treatment failure is crucial for optimizing patient outcomes.
Purpose of the Study:
- To identify risk factors associated with treatment failure in extra-spinal aneurysmal bone cysts.
- To evaluate the recurrence rates based on initial treatment modalities.
- To assess the impact of patient age on treatment outcomes.
Main Methods:
- Multicenter retrospective series of 115 patients with extra-spinal ABCs.
- Follow-up exceeding 12 months.
- Survival analyses including log-rank tests and Cox proportional hazard regression to identify recurrence predictors.
Main Results:
- Patients under 13 years old had a significantly higher risk of recurrence (HR 2.3, p=0.011).
- Surgical curettage resulted in a 27% recurrence rate.
- Initial limited percutaneous curettage during biopsy had a 47% success rate without further intervention.
Conclusions:
- Younger age (<13 years) is a significant risk factor for aneurysmal bone cyst recurrence.
- Extensive surgical curettage is associated with a higher risk of treatment failure.
- Limited percutaneous curettage as an initial procedure shows promise for successful cyst healing.
