In the comparative aspect to show efficacy of combined and complex methods of treatment in giant cell tumor of the long bones.
We have observed 154 patients with giant cell tumor of the long bones. Out of 154 patients males were 73(47.4%) and women 81(52.6%). The age of patients fluctuated from 14 to 60 years, on the average was 28.1 years. In the majority of cases the tumor localized in the femoral (30.6%) and tibial bones (29.8%), less in the humeral bone (9.7%), in the radial bone (8.5%) and in the bones of the foot (3.6%) and fibular bone (1.8%). X-ray investigation in 99 patients (64.3%) revealed alveolar-trabecular, in 32(20.8%) – osteolytic and in 23(14.9%) – mixed form of tumor. With regard to methods of treatment all patients were divided into 3 groups. Group 1 included the patients with excochleation and cementoplasty – 82(53.2%), group 2 – excochleation, cryotherapy and cementoplasty – in 37(24.1%). Group 3 –excochleation and autoplasty – in 35 (22.7%).
All patients were under observation from 6 months to 10 years. Analysis of the frequency of the tumor recurrences in the patients with giant cell tumor of the long bones showed that tumor recurrence, mainly, was revealed in group of patients with big sizes, roentgenologically osteolytic form as well as histologically malignant variant of giant cell tumor. Out of 154 patients in 20(13%) there were noted recurrences of disease and in 4(2,6%) - long-term metastases. The recurrences developed mostly often after operation of excochleation with autoplasty - in 9(5,8%), less often after excochleation and cementoplasty – in 8(5,2) and excochleation, cryoeffect and cementoplasty 3(1,9%). The terms of recurrence appearance were from 6 to 21 months. Due to tumor recurrences in 5 (3,2%) patients there were performed mutilating surgeries and in 10(6,5%) patients segmental resection of the bone with endoprosthesis of the large joints, and in the rest patients – organ-preserving operations.
The results of the analysis showed that frequency of the tumor recurrence after bone-plastic operations in giant cell tumors of the long bones accounts for 13%. The recurrence is revealed mostly often after operation of excochleation and autoplasty.
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All authors have declared no conflicts of interest.