title: Giant cell tumors of the sacrum--a nationwide study on midterm results in 26 patients after intralesional excision.
abstract: OBJECTIVE
  Evaluation of recurrences, complications and function at mid-term follow-up after curettage for sacral giant cell tumor (GCT).
  
  
  METHODS
  We retrospectively studied all 26 patients treated for sacral GCT in the Netherlands (from 1990 to 2010). Median follow-up was 98 (6-229) months. All patients underwent intralesional excision, 21 with local adjuvants, 5 radiotherapy, 3 IFN-α, 1 bisphosphonates. Functional outcome was assessed using Musculoskeletal Tumor Society (MSTS) score. Statistics were performed with Kaplan-Meier, Cox regression, log rank and Mann-Whitney U.
  
  
  RESULTS
  Recurrence rate was 14/26 after median 13 (3-139) months and was highest after isolated curettage (4/5). Soft tissue masses >10 cm increased recurrence risk (HR = 3.3, 95 % CI = 0.81-13, p = 0.09). Complications were reported in 12/26 patients. MSTS was superior in patients without complications (27 vs. 21; p = 0.024).
  
  
  CONCLUSIONS
  Recurrence rate for sacral GCT was highest after isolated curettage, indicating that (local) adjuvant treatment is desired to obtain immediate local control. Complications were common and impaired function.
authors.affiliation: Department of Orthopedic Surgery, Leiden University Medical Center (LUMC), Postzone J11-70, PO Box 9600, 2300 RC, Leiden, The Netherlands, lvanderheijden@lumc.nl.
authors.forename: L
authors.initials: L
authors.lastname: van der Heijden
authors.forename: M A J
authors.initials: MA
authors.lastname: van de Sande
authors.forename: I C M
authors.initials: IC
authors.lastname: van der Geest
authors.forename: H W B
authors.initials: HW
authors.lastname: Schreuder
authors.forename: B J
authors.initials: BJ
authors.lastname: van Royen
authors.forename: P C
authors.initials: PC
authors.lastname: Jutte
authors.forename: J A M
authors.initials: JA
authors.lastname: Bramer
authors.forename: F C
authors.initials: FC
authors.lastname: Öner
authors.forename: A P
authors.initials: AP
authors.lastname: van Noort-Suijdendorp
authors.forename: H M
authors.initials: HM
authors.lastname: Kroon
authors.forename: P D S
authors.initials: PD
authors.lastname: Dijkstra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000401:mortality / Q000601:surgery* / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant / Q000379:methods; D003475:Curettage; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D018212:Giant Cell Tumor of Bone / Q000401:mortality / Q000601:surgery* / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009426:Netherlands; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D012447:Sacrum / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates