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Outcomes of En bloc resection followed by reconstruction of giant cell tumor around knee and distal radius. A case series.

ABSTRACT: Introduction:This study is to evaluate the outcomes of En bloc resection and reconstruction in patients with GCT of the bone around the knee and in the distal radius. Materials and methods:We reviewed 41 cases of GCT of the bone that was treated by En bloc resection around the knee joint and in the distal radius from 2011 to 2018. The local recurrence, metastases, complications and functional score were evaluated for each operation technique. Results:The average of MSTS score for all group was 78% (excellent). In the knee joint, the megaprostheses group had an excellent MSTS score of78.9% and good 21.1%. The MAMC group had an excellent MSTS score of40.0%, good 50.0% and fair 10.0%. One patient in the megaprostheses group had metastasis to the lung and 1 patient in the knee arthrodesis group has a recurrence. Infection occurred in 2 cases of megaprostheses while only 1 case in MAMC. Both of the groups in knee joint GCT had 1 patient with implant loosening. In the distal radius, FVFG group had an excellent MSTS score 100% and NVFG group had an excellent score 77.7%, good 11.1% and fair 11.1%. One patient in the NVFG group had an infection, 1 patient has implant loosening and another one patient had graft failure. Two patients in the NVFG group had a recurrence. No metastasis was found in both of the group types of surgery in distal radius GCT. Conclusion:Functional outcome of a patient with GCT of the bone after En bloc resection and reconstruction with the above techniques had comparable results with previous studies.

SUBMITTER: Kamal AF

PROVIDER: S-EPMC6926124 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Outcomes of En bloc resection followed by reconstruction of giant cell tumor around knee and distal radius. A case series.

Kamal Achmad Fauzi AF Muhamad Almu A

Annals of medicine and surgery (2012) 20191206

<h4>Introduction</h4>This study is to evaluate the outcomes of En bloc resection and reconstruction in patients with GCT of the bone around the knee and in the distal radius.<h4>Materials and methods</h4>We reviewed 41 cases of GCT of the bone that was treated by En bloc resection around the knee joint and in the distal radius from 2011 to 2018. The local recurrence, metastases, complications and functional score were evaluated for each operation technique.<h4>Results</h4>The average of MSTS sco ...[more]

PMID: 31890200

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Project description:ObjectiveThe wrist is the second most commonly involved location for GCTB, while distal ulna is a relatively rare location and limited evidence exists on which surgical approaches and reconstruction techniques are optimal. We carried out a multicenter retrospective study to evaluate the recurrence rate of distal ulna GCTB and the long-term functional outcomes of different surgery options.MethodsAll 28 patients received surgical treatment for distal ulna GCTB in one of three tertiary bone tumor centers between May 2007 and January 2021 with a minimum two-year follow-up. Surgical options included intralesional curettage or en bloc resection (one of 3 types). Functional outcomes were assessed by the MSTS score, the QuickDASH instrument, MWS, and MHQ according to the latest treatment.ResultsOverall recurrence rate was 14.2%. The curettage group (N = 7) had a significantly higher recurrence rate compared to en bloc resection (N = 21) (42.9% vs 4.8%) (mean follow-up: 88.8 mo). Seven patients received the Darrach procedure, 5 received the original Sauvé-Kapandji procedure, and 9 received the modified Sauvé-Kapandji procedure with extensor carpi ulnaris (ECU) tenodesis. Of the 4 patients having a recurrence, 1 received the Darrach EBR, 2 received the modified Sauvé-Kapandji procedure, and 1 received resection for soft tissue recurrence. Only MWS and esthetics in the MHQ scores were different (curettage, Darrach, Sauvé-Kapandji, and Sauvé-Kapandji with ECU tenodesis [MWS: 96.5 ± 1.3 vs 91.5 ± 4.7 vs 90.8 ± 2.8 vs 91.5 ± 3.6; esthetics in MHQ: 98.5 ± 3.1 vs 89.9 ± 4.7 vs 93.8 ± 4.4 vs 92.6 ± 3.8], respectively).ConclusionsEn bloc resection for distal ulna GCTB had a significantly lower recurrence rate compared with curettage and achieved favorable functional outcome scores. Given the higher recurrence rate after curettage, patients should be well informed of the potential benefits and risks of selecting the distal radioulnar joint-preserving procedure. Moreover, reconstructions after tumor resection of the ulna head do not appear to be necessary.

Project description:Although distal pancreatectomy with en bloc celiac resection (DP-CAR) is used to treat locally advanced pancreatic cancer, the advantages and disadvantages of this surgical procedure remain unclear. The purpose of this study was to evaluate its clinical safety and efficacy.Studies regarding DP-CAR were retrieved from the following databases: PubMed, EMBASE, Web of Science, Cochrane Library, and Chinese electronic databases. Articles were selected according to predesigned inclusion criteria, and data were extracted according to predesigned sheets. Clinical, oncologic, and survival outcomes of DP-CAR were systematically reviewed by hazard ratios (HRs) or odds ratio (OR) using fixed- or random-effects models.Eighteen studies were included. DP-CAR had a longer operating time and greater intraoperative blood loss compared to distal pancreatectomy (DP). A high incidence of vascular reconstruction occurred in DP-CAR: 11.53% (95%CI: 6.88-18.68%) for artery and 33.28% (95%CI: 20.45-49.19%) for vein. The pooled R0 resection rate of DP-CAR was 72.79% (95% CI, 46.19-89.29%). Higher mortality and morbidity rates were seen in DP-CAR, but no significant differences were detected compared to DP; the pooled OR was 1.798 for mortality (95% CI, 0.360-8.989) and 2.106 for morbidity (95% CI, 0.828-5.353). The pooled incidence of postoperative pancreatic fistula (POPF) was 31.31% (95%CI, 23.69-40.12%) in DP-CAR, similar to that of DP (OR = 1.07; 95%CI, 0.52-2.20). The pooled HR against DP-CAR was 5.67 (95%CI, 1.48-21.75) for delayed gastric emptying. The pooled rate of reoperation was 9.74% (95%CI, 4.56-19.59%) in DP-CAR. The combined 1-, 2-, and 3-year survival rates in DP-CAR were 65.22% (49.32-78.34%), 30.20% (21.50-40. 60%), and 18.70% (10.89-30.13%), respectively. The estimated means and medians for survival time in DP-CAR patients were 24.12 (95%CI, 18.26-29.98) months and 17.00 (95%CI, 13.52-20.48) months, respectively. There were no significant differences regarding postoperative 1-, 2-, and 3-year survival rates between DP-CAR and DP, whereas DP-CAR had a better 1-year survival rate compared to palliative treatments. The pooled HR for overall survival between DP-CAR and DP was 1.36 (95%CI: 0.997-1.850); the pooled HR favoring DP-CAR was 0.38 (95%CI: 0.25-0.58) for overall survival compared to palliative treatments. The rate of cancer-related pain relief from DP-CAR was 89.20% (95%CI, 77.85-95.10%). The pooled incidence of postoperative diarrhea was 37.10% (95%CI, 20.79-57.00%); however, most diarrhea was effectively controlled.DP-CAR is feasible and acceptable in terms of its survival benefits and improved quality of life. However, it should be performed with caution due to its high postoperative morbidity.

Dataset Information

Outcomes of En bloc resection followed by reconstruction of giant cell tumor around knee and distal radius. A case series.

Publications

Outcomes of En bloc resection followed by reconstruction of giant cell tumor around knee and distal radius. A case series.

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