Use of Surgical Adjuvants Does Not Decrease Recurrence of Aneurysmal Bone Cysts in Surgical Intervention With Pediatric Patients.
Use of Surgical Adjuvants Does Not Decrease Recurrence of Aneurysmal Bone Cysts in Surgical Intervention With Pediatric Patients.
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在儿科患者的手术干预中，使用手术辅助剂并不能减少动脉瘤性骨囊肿的复发。
DOI：
10.1097/bpo.0000000000002536
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Christ,AlexanderB
中科院分区：
文献类型：
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作者：
Gettleman,BrandonS;Padilla,AbigailN;Kumar,Shourya;Wren,TishyaAL;Miller,Joseph;Pawel,BruceR;Tolo,VernonT;Christ,AlexanderB
背景：动脉瘤性骨囊肿（ABCs）是一种良性活动性肿瘤，通常需要有或没有佐剂的病灶内刮除。本研究的主要目的是分析小儿abc患者手术佐剂的使用是否会影响复发。次要目的检查基于年龄、性别和身体接触的复发率。方法：对2004年至2020年在某三级儿科医院进行回顾性分析。纳入标准包括手术治疗组织学证实的abc患者，随访至少6个月。排除因肿瘤复发或治疗记录不完整的患者。收集患者的人口统计资料、病变部位、治疗方法和复发率。采用STATA进行统计分析。结果：129例患者（男74例，女55例），平均年龄11.5±4.1岁，平均随访29.0±25.4个月。abc最常见的部位是股骨和胫骨。53.5%的患者肿瘤临近物理，28.7%的患者无物理接触，17.8%的患者影像学检查不充分。129例中有91例（70.5%）使用了手术辅助剂（高速毛刺、凝血、液氮和/或过氧化氢）。接受辅助治疗和未接受辅助治疗的患者的复发率无显著差异（25.3% vs 23.7%， P= 1.000）。物理接触与复发也无显著相关性（P= 0.146）。最后，6岁以下的患者复发的可能性明显高于6岁及以上的患者（66.7% vs 21.7%， P= 0.007）。结论：我们的研究发现手术佐剂的使用与病灶内刮除abc后复发的风险之间没有关联。虽然我们的研究确实表明6岁或6岁以下的患者复发率增加，但没有发现与身体接触或性别有关的显著关联。这些数据表明手术辅助可能不会影响abc患儿的复发率。证据等级：三级。本回顾性综述比较了基于手术辅助选择的复发率。
Background:Aneurysmal bone cysts (ABCs) are benign active tumors often requiring intralesional curettage with or without adjuvants. The primary aim of this study was to analyze whether recurrence is influenced by the use of surgical adjuvants in pediatric patients with ABCs. Secondary aims examined recurrence rates based on age, sex, and physeal contact.Methods:A retrospective review was performed at a tertiary pediatric hospital from 2004 to 2020. Inclusion criteria consisted of patients treated surgically for histologically confirmed ABCs with a minimum of 6 months follow-up. Patients with treatment for a recurrent tumor or incomplete records were excluded. Patient demographics, location of the lesion, treatment technique, and incidence of recurrence were collected. Statistical analyses were performed using STATA.Results:There were 129 patients (74 males and 55 females) with a mean age of 11.5±4.1 years and an average follow-up of 29.0±25.4 months. The most common locations for ABCs were the femur and tibia. Of the patients, 53.5% had tumors abutting the physis, 28.7% had no physeal contact, and 17.8% had insufficient imaging to evaluate physeal contact. Surgical adjuvants (high-speed burr, coagulation, liquid nitrogen, and/or hydrogen peroxide) were used in 91 of the 129 cases (70.5%). There was no significant difference in recurrence when comparing those who received an adjuvant and those who did not (25.3% vs 23.7%, P= 1.000). Physeal contact was also not significantly associated with recurrence (P= 0.146). Finally, patients younger than 6 years old were significantly more likely to have recurrence compared with those 6 years old or older (66.7% vs 21.7%, P= 0.007).Conclusion:Our study found no association between the use of surgical adjuvants and the risk of recurrence after intralesional curettage for ABCs. Although our study did demonstrate that patients 6 years old or younger had an increased rate of recurrence, no significant association was found regarding physeal contact or sex. These data indicate that surgical adjuvant may not affect the recurrence rates of pediatric patients with ABCs.Level of Evidence:Level III. This retrospective review compares rates of recurrence based on the choice of surgical adjuvant.