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Analysis of Local Recurrence of Giant Cell Tumor

거대세포종의 국소 재발 분석

  • Cheon, Sang-Ho (Department of Orthopedic Surgery, Kyungpook University College of Medicine) ;
  • Park, Il-Hyung (Department of Orthopedic Surgery, Kyungpook University College of Medicine) ;
  • Cho, Hwan-Seong (Department of Orthopedic Surgery, Kyungpook University College of Medicine) ;
  • Kim, Do-Hyung (Department of Orthopedic Surgery, Kyungpook University College of Medicine)
  • 천상호 (경북대학교 의과대학 정형외과학교실) ;
  • 박일형 (경북대학교 의과대학 정형외과학교실) ;
  • 조환성 (경북대학교 의과대학 정형외과학교실) ;
  • 김도형 (경북대학교 의과대학 정형외과학교실)
  • Received : 2010.07.30
  • Accepted : 2010.10.20
  • Published : 2010.12.30

Abstract

Purpose: This study was aimed to evaluate the recurrence rate of a giant cell tumor (GCT) of the bone. Materials and Methods: The medical records of fifty four patients who were diagnosed with a giant cell tumor of the bone between March 1980 and December 2008 were analysed retrospectively. Among 54 patients, 27 were men, remaining 27 were women with the mean age of 33.1 years (range, 13-67 years). The mean duration of follow-up was 67.1 months. Results: Twenty-one patients (38.9%) had a local recurrence. The mean time to recurrence was 21.5 months (range, 2-59 months). The local recurrence rate of the upper extremities was higher than that of lower extremities. According to Campanacci classification, patients with a grade I diseae had lower recurrence rate than those with grade II or III disease. There was no significant differences in the recurrence rates based on cryotherapy, the filling of bone cement or bone grafts and surgical margin. Conclusion: To prevent local recurrence of GCT of bone, curettage of the tumor and elimination of the remaining cells are more important than adjuvant therapy.

목적: 골 거대세포종 환자들의 치료결과 및 재발률을 평가하여 보고하고자 하였다. 대상 및 방법: 1980년 3월부터 2008년 12월까지 본원에서 치료 받은 거대세포종 환자 중 최소 12개월 이상 추적관찰이 가능하였던 54예에 대하여 후향적으로 조사하였다. 54예 중 남자 27예, 여자 27예로 평균 나이는 33.1세(13-67세)였다. 평균 추시 기간은 67개월(12-104개월)이었다. 결과: 54예 중 21예(38.9%)에서 국소재발이 발생하였으며 술 후 재발까지의 기간은 평균 21.5개월이었다. 국소재발에 통계적으로 유의한 영향을 가진 인자로는 해부학적 위치와 임상적 병기로 하지에서 상지보다 낮은 재발률을 보였으며(p=0.032), Campanacci 분류 grade I이 grade II와 grade III보다 재발률이 낮았다. 소파술 후 골시멘트 충진을 시행한 군(28예)과 동종골 이식을 시행한 군(18예) 사이에도 국소 재발률에 대해 통계적으로 유의한 차이를 보이지 않았고, 소파술 후 국소 보조요법으로 냉동을 시행한 군과 시행하지 않은 군에서도 통계적 유의성은 없었다. 결론: 골 거대세포종의 국소 재발을 방지하기 위해서는 종양세포의 철저한 제거가 여러 부가적인 처치보다 더 중요하다고 판단된다.

Keywords

References

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