Giant cell tumors of the sacrum—a nationwide study on midterm results in 26 patients after intralesional excision

• Published in: European spine journal 2014-09, Vol.23 (9), p.1949-1962
• Main Authors: van der Heijden, L., van de Sande, M. A. J., van der Geest, I. C. M., Schreuder, H. W. B., van Royen, B. J., Jutte, P. C., Bramer, J. A. M., Öner, F. C., van Noort-Suijdendorp, A. P., Kroon, H. M., Dijkstra, P. D. S.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Bone Density Conservation Agents - therapeutic use; Bone Neoplasms - mortality; Bone Neoplasms - surgery; Bone Neoplasms - therapy; Chemoradiotherapy, Adjuvant - methods; Curettage; Diphosphonates - therapeutic use; Female; Follow-Up Studies; Giant Cell Tumor of Bone - mortality; Giant Cell Tumor of Bone - surgery; Giant Cell Tumor of Bone - therapy; Humans; Kaplan-Meier Estimate; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local; Netherlands; Neurosurgery; Original Article; Postoperative Complications - mortality; Retrospective Studies; Risk Factors; Sacrum - surgery; Surgical Orthopedics; Treatment Outcome; Young Adult
• ISSN: 0940-6719; 1432-0932
• DOI: 10.1007/s00586-014-3263-5

Purpose Evaluation of recurrences, complications and function at mid-term follow-up after curettage for sacral giant cell tumor (GCT). Methods We retrospectively studied all 26 patients treated for sacral GCT in the Netherlands (from 1990 to 2010). Median follow-up was 98 (6–229) months. All patients underwent intralesional excision, 21 with local adjuvants, 5 radiotherapy, 3 IFN-α, 1 bisphosphonates. Functional outcome was assessed using Musculoskeletal Tumor Society (MSTS) score. Statistics were performed with Kaplan–Meier, Cox regression, log rank and Mann–Whitney U . Results Recurrence rate was 14/26 after median 13 (3–139) months and was highest after isolated curettage (4/5). Soft tissue masses >10 cm increased recurrence risk (HR = 3.3, 95 % CI = 0.81–13, p  = 0.09). Complications were reported in 12/26 patients. MSTS was superior in patients without complications (27 vs. 21; p  = 0.024). Conclusion Recurrence rate for sacral GCT was highest after isolated curettage, indicating that (local) adjuvant treatment is desired to obtain immediate local control. Complications were common and impaired function.