title: Intralesional excision versus wide resection for giant cell tumor involving the acetabulum: which is better?
abstract: BACKGROUND
  Because of the anatomic complexity of the pelvis, there is no standard surgical treatment for giant cell tumors (GCTs) of the pelvic bones, especially in the periacetabular region. Treatment options include intralesional curettage with or without adjunctive techniques and wide resection. The best surgical treatment of a pelvic GCT remains controversial.
  
  
  OBJECTIVE
  We compared wide resection and intralesional excision in terms of (1) local control, (2) function, and (3) complications.
  
  
  METHODS
  We retrospectively identified 27 patients with periacetabular benign GCTs who underwent surgery from July 1999 to July 2009. Intralesional surgery was performed in 13 patients and wide resection in 14 patients. We determined surgical complications, local disease control, and Musculoskeletal Tumor Society (MSTS) 93 functional score. The minimum followup was 18 months (mean, 50 months; range, 18-121 months).
  
  
  RESULTS
  Four of 13 patients who had intralesional surgery and none of 14 who had wide resection had local recurrence. The mean functional score was 24 for the 13 patients who underwent intralesional surgery and 22 for the 14 patients who had wide resection. One minor and one major complication occurred among patients who underwent intralesional surgery and one minor and six major complications occurred among patients who underwent wide resection.
  
  
  CONCLUSIONS
  Even with a higher complication rate with wide resection and prosthetic reconstruction, we believe the lower local recurrence rate makes wide resection a reasonable option for patients with extensive and/or aggressive GCTs involving the acetabulum.
  
  
  METHODS
  Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
authors: Musculoskeletal Tumor Center, Peking University, People's Hospital, Beijing 100044, China. bonetumorguowei@yahoo.cn
authors: Wei
authors: W
authors: Guo
authors: Xin
authors: X
authors: Sun
authors: Jie
authors: J
authors: Zang
authors: Huayi
authors: H
authors: Qu
mesh_terms: D000077:Acetabulum / Q000473:pathology / Q000601:surgery; D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D018212:Giant Cell Tumor of Bone / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D010384:Pelvic Bones / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome