Journal of Orthopaedic Surgery 2016;24(3):427-8
Letters to the Editor
Wide resection versus curettage with adjuvant therapy for giant cell tumour of bone
To the Editor:
We read with interest the article by Kamal et al.1 The authors commented that there was no association between type of surgery and tumour recurrence, metastasis, or outcome. How many patients had pathological fracture? What were the fracture characteristics? What was the outcome in patients with pathological fracture treated with curettage and what was the recurrence rate? What kind of adjuvant therapy was used? What type of reconstruction was used following wide resection around the knee joint?
Patients with and without a pathological fracture at
the time of presentation have been reported to have a comparable local recurrence rate.2 Different adjuvant methods and their combination lead to variable outcomes.3
Abhijeet Ashok Salunke,1 Subodh Pathak,2 Tapan Singh Chauhan,1 Jaymin Shah1
1Gujarat Cancer Research Institute, Ahemdabad, Gujarat, India
2Pramukswami Medical College, Anand, Gujarat, India
REFERENCES
1. Kamal AF, Simbolon EL, Prabowo Y, Hutagalung EU. Wide resection versuscurettage with adjuvant therapy for giant cell tumour of bone. J Orthop Surg (Hong Kong) 2016;24:228–31.
2. Salunke AA, Chen Y, Chen X, Tan JH, Singh G, Tai BC, et al. Does pathological fracture affect the rate of local recurrence in patients with a giant cell tumour of bone?: a meta-analysis. Bone Joint J 2015;97-B:1566–71.
3. Saibaba B, Chouhan DK, Kumar V, Dhillon MS, Rajoli SR. Curettage and reconstruction by the sandwich technique for giant cell tumours around the knee. J Orthop Surg (Hong Kong) 2014;22:351–5.
Authors’ reply
In our study, 18 patients had giant cell tumour of bone and pathological fracture; all were tumour stage 3. Of them, 15 underwent wide resection and 3 underwent curettage followed by adjuvant therapy using peroxide 3% and alcohol 95%. One of the latter 3 patients had recurrence but no lung metastasis. The type of reconstruction used following wide resection around the knee joint included endoprothesis (megaprosthesis or long stem for revision total knee
replacement) or arthrodesis with Juvara technique or nailing (with or without plating) with bone cement spacer or free fibular vascularised graft.
Achmad Fauzi Kamal, Edi Leonardo Simbolon, Yogi Prabowo, Errol Untung Hutagalung Department of Orthopaedic and Traumatology, Cipto Mangunkusumo National Central Hospital / Faculty of Medicine Universitas Indonesia, Indonesia
