TY - JOUR
T1 - Giant Cell Tumors of the Upper Extremity
T2 - Predictors of Recurrence
AU - Lans, Jonathan
AU - Oflazoglu, Kamil
AU - Lee, Hang
AU - Harness, Neil G
AU - Castelein, René M
AU - Chen, Neal C
AU - Lozano Calderón, Santiago A
N1 - Publisher Copyright:
© 2020 American Society for Surgery of the Hand
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/8
Y1 - 2020/8
N2 - 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.
AB - 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.
KW - Giant cell tumor
KW - intralesional curettage
KW - orthopedic oncology
KW - surgical treatment
KW - upper extremity tumors
UR - http://www.scopus.com/inward/record.url?scp=85087212794&partnerID=8YFLogxK
U2 - 10.1016/j.jhsa.2020.04.020
DO - 10.1016/j.jhsa.2020.04.020
M3 - Article
C2 - 32616409
SN - 0363-5023
VL - 45
SP - 738
EP - 745
JO - Journal of Hand Surgery (Am)
JF - Journal of Hand Surgery (Am)
IS - 8
ER -