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Intralesional Excision versus Wide Resection for Giant Cell Tumor Involving the Acetabulum: Which is Better?

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Because of the anatomic complexity of the pelvis, there is no standard surgical treatment for giant cell tumors (GCTs) of the pelvic bones, especially in the periacetabular region. Treatment options include intralesional curettage with or without adjunctive techniques and wide resection. The best surgical treatment of a pelvic GCT remains controversial.

Questions/purposes

We compared wide resection and intralesional excision in terms of (1) local control, (2) function, and (3) complications.

Methods

We retrospectively identified 27 patients with periacetabular benign GCTs who underwent surgery from July 1999 to July 2009. Intralesional surgery was performed in 13 patients and wide resection in 14 patients. We determined surgical complications, local disease control, and Musculoskeletal Tumor Society (MSTS) 93 functional score. The minimum followup was 18 months (mean, 50 months; range, 18–121 months).

Results

Four of 13 patients who had intralesional surgery and none of 14 who had wide resection had local recurrence. The mean functional score was 24 for the 13 patients who underwent intralesional surgery and 22 for the 14 patients who had wide resection. One minor and one major complication occurred among patients who underwent intralesional surgery and one minor and six major complications occurred among patients who underwent wide resection.

Conclusions

Even with a higher complication rate with wide resection and prosthetic reconstruction, we believe the lower local recurrence rate makes wide resection a reasonable option for patients with extensive and/or aggressive GCTs involving the acetabulum.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgment

We thank Yanchun She for assistance with data collection.

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Correspondence to Wei Guo MD, PhD.

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Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Guo, W., Sun, X., Zang, J. et al. Intralesional Excision versus Wide Resection for Giant Cell Tumor Involving the Acetabulum: Which is Better?. Clin Orthop Relat Res 470, 1213–1220 (2012). https://doi.org/10.1007/s11999-011-2190-6

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