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

Öz

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.

Anahtar Kelimeler

• 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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