Dev hücreli kemik tümörü: Lokal nüks ile ilişkili olan cerrahi dışı faktörler

Year 2014, , 136 - 140, 18.04.2014

Luiz Eduardo Moreira Teixeira José Carlos Souza Vilela Ricardo Horta Miranda Anderson Humberto Gomes Frederico Alves Costa Vinicius Carvalho De Faria

https://doi.org/10.3944/AOTT.2014.2714

Abstract

Amaç: Bu çalışmanın amacı, dev hücreli tümör tanısı konulmuş hastalarda nüks oranını belirlemek ve nüks oranlarına etki eden faktörleri değerlendirmekti.

Çalışma planı: 2000–2009 döneminde dev hücreli tümör (DHT) tanısı konulan 41 hastaya (22 kadın, 19 erkek; yaş ortalaması 34.22±9.7) cerrahi ve adjuvan tedaviler uygulandı. Ortalama takip süresi 40.17±22.08 aydı. DHT’nin ortalama çapı 8.51±3.69 cm idi. Campanacci ve ark. tarafından geliştirilen sınıflandırmaya göre, 18 hastanın tümörü evre II; 23 hastanın evre III olarak sınıflandı. Lezyonun cerrahi sınırı, hastaların %60.9’unda intralezyonal rezeksiyon ve küretaj; %39.1’inde ise marjinal veya geniş rezeksiyondu.

Bulgular: 41 hastanın 9’unda (%22) tümörün tekrarlandığı görüldü. Lokal nüks ile cinsiyet (p=0.436), yaş (p=0.310), tümör lokalizasyonu (p=0.940), rezeksiyon genişliği (p=0.400) ve kullanılan dolgu materyeli tipi (PMMA veya otogreft) (p=0.680) arasında bir ilişki bulunmadı. Diğer taraftan lokal nüks ile Campanacci evre III sınıfında olma (p=0.028), ve tümörün büyüklüğü (p=0.034) arasında anlamlı bir ilişki saptandı.

Çıkarımlar: Sonuçlarımız Campanacci evrelemesinde III evrede olmanın ve tümör büyüklüğünün DHT rezeksiyonu sonrasında lokal nüks açısından risk faktörü olduğunu düşündürmektedir.

Keywords

Dev hücreli tümör; neoplazma; prognoz.

Giant cell tumors of bone: nonsurgical factors associated with local recurrence

Abstract

Objective: To determine the rate of giant cell tumor (GCT) recurrence and evaluate the factors associated with its recurrence in patients who underwent surgery and submitted to only one adjuvant method.

Methods: Forty–one patients (22 female, 19 male; mean age: 34.22±9.70 years) with GCT, who underwent surgical and one adjuvant treatment, were evaluated after a mean follow-up period of 40.17±22.08 months. The average tumor size was 8.51 ± 3.69 cm. The tumors in 18 patients (43.9%) were grade II and in 23 patients (56.1%) grade III, according to the system developed by Campanacci et al. The surgical margin was intralesional resection and curettage in 60.9% of the patients, and marginal or wide resection in 39.1%.

Results: Nine (22%) of the 41 patients had recurrence. None of the gender (p=0.436), age (p=0.310), site of the tumor (p=0.940), surgical margins (p=0.400) and the type of the filling material (PMMA or autograft) (p=0.680) had an association with recurrence. However, Campanacci grade III (p=0.028) and the size of the tumor (p=0.034) was associated with the recurrence.

Conclusion: Tumor size and tumor grade III according to the Campanacci system appear to be risk factors for local recurrence after the local resection of GCT.

Keywords

Giant cell tumor, neoplasm, prognosis

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