title: Current treatment of sacral giant cell tumour of bone: a review.
abstract: Sacral giant cell tumour of bone has an insidious onset and slow growth rate, making early diagnosis difficult. The tumour has a high recurrence rate and is often fatal. Magnetic resonance imaging and computed tomography (CT), including CT-guided fine-needle biopsy, are useful for early  diagnosis. Although therapy for sacral giant cell tumour often involves surgical resection and reconstruction challenges, improvements in various treatment modalities, including arterial embolization and radiotherapy, have widened the effective treatment options. The current surgical and adjuvant  treatment modalities available for the management of sacral giant cell tumour are systematically reviewed and a suggested treatment algorithm is provided. En bloc excision remains the surgical procedure of choice, with functional reconstruction important in cases where the lesion is  high in the sacrum. The use of adjuvant radiotherapy and chemotherapy remains controversial and should be studied further. Determination of the optimum treatment for sacral giant cell tumour will require randomized controlled trials. Early diagnosis, complete surgical resection with tumour-free  margins and comprehensive treatment are important for local tumour control and improved outcome.
authors.affiliation: Department of Orthopaedics, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: C C
authors.initials: CC
authors.lastname: Shen
authors.forename: H
authors.initials: H
authors.lastname: Li
authors.forename: Z L
authors.initials: ZL
authors.lastname: Shi
authors.forename: H M
authors.initials: HM
authors.lastname: Tao
authors.forename: Z M
authors.initials: ZM
authors.lastname: Yang
mesh_terms: D003131:Combined Modality Therapy; D055088:Early Detection of Cancer; D004621:Embolization, Therapeutic / Q000379:methods; D018212:Giant Cell Tumor of Bone / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D009364:Neoplasm Recurrence, Local; D011859:Radiography; D019651:Plastic Surgery Procedures; D012447:Sacrum / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome