Long-term administration of bisphosphonate to reduce local recurrence of sacral giant cell tumor after nerve-sparing surgery.
OBJECTIVE The objective of this study was to investigate the effect of long-term bisphosphonate treatment on reducing local recurrence of sacral giant cell tumors (GCTs) after nerve-sparing surgery. METHODS Thirty-five consecutive patients with sacral GCTs who received treatment in Shanghai Changzheng Hospital between January 2000 and December 2010 were included in this study. Between January 2007 and December 2010, 19 patients received bisphosphonates following nerve-sparing surgery. Before January 2007, 16 patients received nerve-sparing surgery alone, and these cases were included as the control group. The difference in clinical data between the groups was compared by Student's t-test and 2-tailed chi-square or Fisher's exact test. The postoperative recurrence-free survival (RFS) and overall survival (OS) rates were estimated by the Kaplan-Meier method and compared between the groups by log-rank test. A p value < 0.05 was considered statistically significant. RESULTS All of the patients had relatively good nerve function. The clinical data were homogeneous between the groups. The local recurrence rate was 10.53% (2 of 19) in the bisphosphonate treatment group and 43.75% (7 of 16) in the control group. The log-rank test showed that the 3-year RFS and 3-year OS in the bisphosphonate treatment group were significantly higher than those in the control group (RFS 89.5% vs 56.3%, p = 0.04; OS 100% vs 81.3%, p = 0.05). CONCLUSIONS The long-term use of bisphosphonates after nerve-sparing surgery is a viable option for the treatment of sacral GCTs. This approach could reduce local recurrences while preserving nerve function.
Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, Shanghai.
Wei
W
Xu
Department of Spine Surgery, First Affiliated Hospital of Wenzhou Medical University, Zhejiang; and.
Yu
Y
Wang
Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, Shanghai.
Jing
J
Wang
Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, Shanghai.
Xinghai
X
Yang
Department of Spine Surgery, Qingdao Central Hospital, Qingdao, Shandong, China.
Weibo
W
Liu
Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, Shanghai.
Wang
W
Zhou
Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, Shanghai.
Tielong
T
Liu
Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, Shanghai.
Jianru
J
Xiao
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D018212:Giant Cell Tumor of Bone / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D019635:Neurosurgical Procedures; D012189:Retrospective Studies; D012447:Sacrum / Q000601:surgery*; D013125:Spinal Neoplasms / Q000188:drug therapy / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
D000970:Antineoplastic Agents; D004164:Diphosphonates
GCT = giant cell tumor; OS = overall survival; PAE = preoperative selective artery embolism; PAR = postoperative adjuvant radiotherapy; RFS = recurrence-free survival; bisphosphonate; giant cell tumor; nerve-sparing surgery; oncology; overall survival; recurrence-free survival; sacral; sacrum