Risk factors for the local recurrence of giant cell tumours of the sacrum treated with nerve-sparing surgery
| Autor: | Yongzhao Zhao, Tao Ji, Taiqiang Yan, Rongli Yang, Wei Guo, Xiaodong Tang |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Giant Cell Tumor of Bone Male medicine.medical_specialty Sacrum Nerve-sparing surgery Intraoperative Neurophysiological Monitoring business.industry Giant cell tumours Surgery Curettage Giant cell Chemotherapy Adjuvant Risk Factors medicine Humans Orthopedics and Sports Medicine Female Neoplasm Recurrence Local business Retrospective Studies |
| Zdroj: | The bonejoint journal. (10) |
| ISSN: | 2049-4408 |
| Popis: | Aims There is a lack of evidence about the risk factors for local recurrence of a giant cell tumour (GCT) of the sacrum treated with nerve-sparing surgery, probably because of the rarity of the disease. This study aimed to answer two questions: first, what is the rate of local recurrence of sacral GCT treated with nerve-sparing surgery and second, what are the risk factors for its local recurrence? Methods A total of 114 patients with a sacral GCT who underwent nerve-sparing surgery at our hospital between July 2005 and August 2017 were reviewed. The rate of local recurrence was determined, and Kaplan-Meier survival analysis carried out to evaluate the mean recurrence-free survival. Possible risks factors including demographics, tumour characteristics, adjuvant therapy, operation, and laboratory indices were analyzed using univariate analysis. Variables with p < 0.100 in the univariate analysis were further considered in a multivariate Cox regression analysis to identify the risk factors. Results The rate of local recurrence of sacral GCT treated with nerve-sparing surgery was 28.95% (33/114). Multivariate Cox regression analysis showed that large tumour size (> 8.80 cm) (hazard ratio (HR) 3.16; 95% confidence interval (CI) 1.27 to 7.87; p = 0.014), high neutrophil-to-lymphocyte ratio (NLR) (> 2.09) (HR 3.13; 95% CI 1.28 to 7.62; p = 0.012), involvement of a sacroiliac joint (HR 3.09; 95% CI 1.06 to 9.04; p = 0.039), and massive intraoperative blood loss (> 1,550 ml) (HR 2.47; 95% CI 1.14 to 5.36; p = 0.022) were independent risk factors for local recurrence. Conclusion Patients with a sacral GCT who undergo nerve-sparing surgery have a local recurrence rate of 29%. Large tumour size, high NLR, involvement of a sacroiliac joint, and massive intraoperative blood loss are independent risk factors. Cite this article: Bone Joint J 2020;102-B(10):1392–1398. |
| Databáze: | OpenAIRE |
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