中华骨科杂志
中華骨科雜誌
중화골과잡지
CHINESE JOURNAL OF ORTHOPAEDICS
2012年
11期
1040-1047
,共8页
王晗%胡永成%于秀淳%王臻%吴苏稼%叶招明%万宁军%徐明%朱皓东%林秾%胡波%袁斌斌
王晗%鬍永成%于秀淳%王臻%吳囌稼%葉招明%萬寧軍%徐明%硃皓東%林秾%鬍波%袁斌斌
왕함%호영성%우수순%왕진%오소가%협초명%만저군%서명%주호동%림농%호파%원빈빈
膝关节%巨细胞瘤,骨%预后,多中心研究
膝關節%巨細胞瘤,骨%預後,多中心研究
슬관절%거세포류,골%예후,다중심연구
Knee joint%Giant cell tumor of bone%Prognosis%Multicenter studies
目的 回顾性分析多中心膝关节周围骨巨细胞瘤的治疗现状,探讨影响手术方案选择、肿瘤复发以及肢体功能的相关危险因素.方法 收集5个骨肿瘤治疗中心2000年3月至2012年5月病理学确诊并经手术治疗的222例膝关节周围骨巨细胞瘤患者,男120例,女102例；年龄(35.5±12.3)岁.肿瘤行囊内刮除术、切刮除术或边缘切除术.分析流行病学、形态学、影像学因素和临床特征,探索术后肿瘤复发、手术方式、术后肢体功能的相关影响因素.结果 行囊内刮除128例(57.6％),切刮除术13例(5.8％),边缘切除术79例(35.5％).159例患者获得随访,随访率为71.6％.术后23例复发,复发率14.5％(23/159),术后至复发的时间(23.9±22.3)个月.囊内刮除术后复发率为19.0％,切刮除术为0,边缘切除术为8.9％,手术方式是影响术后复发的唯一因素.复发肿瘤的手术方式与首诊原发肿瘤的差异有统计学意义,复发患者更倾向于边缘切除.病理性骨折、Campanacci分级、Enneking骨肿瘤分期以及有无软组织肿块可明显影响手术方式的选择.囊内刮除术后患者的国际骨肿瘤协会(Musculoskeletal Tumor Society,MSTS)评分明显优于边缘切除,Enneking分期、有无软组织肿块、首诊原复发亦可明显影响患者术后肢体功能.结论 手术切除方式是同时影响术后复发与肢体功能的唯一因素.
目的 迴顧性分析多中心膝關節週圍骨巨細胞瘤的治療現狀,探討影響手術方案選擇、腫瘤複髮以及肢體功能的相關危險因素.方法 收集5箇骨腫瘤治療中心2000年3月至2012年5月病理學確診併經手術治療的222例膝關節週圍骨巨細胞瘤患者,男120例,女102例；年齡(35.5±12.3)歲.腫瘤行囊內颳除術、切颳除術或邊緣切除術.分析流行病學、形態學、影像學因素和臨床特徵,探索術後腫瘤複髮、手術方式、術後肢體功能的相關影響因素.結果 行囊內颳除128例(57.6％),切颳除術13例(5.8％),邊緣切除術79例(35.5％).159例患者穫得隨訪,隨訪率為71.6％.術後23例複髮,複髮率14.5％(23/159),術後至複髮的時間(23.9±22.3)箇月.囊內颳除術後複髮率為19.0％,切颳除術為0,邊緣切除術為8.9％,手術方式是影響術後複髮的唯一因素.複髮腫瘤的手術方式與首診原髮腫瘤的差異有統計學意義,複髮患者更傾嚮于邊緣切除.病理性骨摺、Campanacci分級、Enneking骨腫瘤分期以及有無軟組織腫塊可明顯影響手術方式的選擇.囊內颳除術後患者的國際骨腫瘤協會(Musculoskeletal Tumor Society,MSTS)評分明顯優于邊緣切除,Enneking分期、有無軟組織腫塊、首診原複髮亦可明顯影響患者術後肢體功能.結論 手術切除方式是同時影響術後複髮與肢體功能的唯一因素.
목적 회고성분석다중심슬관절주위골거세포류적치료현상,탐토영향수술방안선택、종류복발이급지체공능적상관위험인소.방법 수집5개골종류치료중심2000년3월지2012년5월병이학학진병경수술치료적222례슬관절주위골거세포류환자,남120례,녀102례；년령(35.5±12.3)세.종류행낭내괄제술、절괄제술혹변연절제술.분석류행병학、형태학、영상학인소화림상특정,탐색술후종류복발、수술방식、술후지체공능적상관영향인소.결과 행낭내괄제128례(57.6％),절괄제술13례(5.8％),변연절제술79례(35.5％).159례환자획득수방,수방솔위71.6％.술후23례복발,복발솔14.5％(23/159),술후지복발적시간(23.9±22.3)개월.낭내괄제술후복발솔위19.0％,절괄제술위0,변연절제술위8.9％,수술방식시영향술후복발적유일인소.복발종류적수술방식여수진원발종류적차이유통계학의의,복발환자경경향우변연절제.병이성골절、Campanacci분급、Enneking골종류분기이급유무연조직종괴가명현영향수술방식적선택.낭내괄제술후환자적국제골종류협회(Musculoskeletal Tumor Society,MSTS)평분명현우우변연절제,Enneking분기、유무연조직종괴、수진원복발역가명현영향환자술후지체공능.결론 수술절제방식시동시영향술후복발여지체공능적유일인소.
Objective To retrospectively analyze treatment status quo of giant cell tumor of bone around the knee in several institutes,and to investigate risk factors affecting selection of surgical manners,tumor recurrence,and functional outcomes.Methods A total of 222 patients with giant cell tumor of bone around the knee confirmed by pathology,who had undergone surgical treatment in 5 institutes from March 2000 to May 2012,were enrolled in this study.There were 120 males and 102 females,with an average age of 35.5 years.The epidemiology,clinical and radiographic features and risk factors affecting selection of surgical manners,tumor recurrence,and functional outcomes were analyzed.Results Intralesional curettage was performed in 128 patients(57.6％),intralesional curettage combined with partial resection in 13 patients (5.8％),and marginal excision in 79 patients (35.5％).A total of 159 patients were followed up.The local recurrence rate was 19.0％ for patients treated with intralesional curettage,8.9％ for marginal excision and 0％ for intralesional curettage combined with partial resection,and the total local recurrence rate was 14.5％(23/159).The mean duration from primary operation to recurrence was 23.9 months.Univariate analysis indicated that surgical manner was the only factor affecting local recurrence.Pathological fracture,Campanacci grades,Enneking system as well as soft tissue mass had a significant influence on the selection of surgical manners.The mean MSTS score after intralesional curettage was obviously higher than that after marginal excision.Conclusion The surgical manner is the only factor affecting local recurrence and limb function.
