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Effect of Local Adjuvants Following Curettage of Benign and Intermediate Tumours of Bone: A Systematic Review of the Literature.
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- Author(s): Smolle, Maria Anna1 (AUTHOR) ; Roessl, Veronika1 (AUTHOR); Leithner, Andreas1 (AUTHOR)
- Source:
Cancers. Sep2023, Vol. 15 Issue 17, p4258. 14p.- Subject Terms:
- Source:
- Additional Information
- Abstract: Simple Summary: Benign and intermediate bone tumours are often treated by intralesional curettage together with local adjuvants in order to the reduce risk of local relapse. However, the role of different adjuvants used is still discussed controversially. In the present systematic literature review, altogether 3316 cases of benign/intermediate bone tumours were summarised with regards to the use of local adjuvants, as well as their respective impact on local recurrence. Overall, 32 different combinations of local adjuvants were identified. Although some tumour entities may benefit from the addition of a local adjuvant, the main treatment step remains thorough curettage of the lesion. Local adjuvants are used upon intralesional resection of benign/intermediate bone tumours, aiming at reducing the local recurrence (LR) rate. However, it is under debate whether, when and which local adjuvants should be used. This PRISMA-guideline based systematic review aimed to analyse studies reporting on the role of adjuvants in benign/intermediate bone tumours. All original articles published between January 1995 and April 2020 were potentially eligible. Of 344 studies identified, 58 met the final inclusion criteria and were further analysed. Articles were screened for adjuvant and tumour type, follow-up period, surgical treatment, and development of LR. Differences in LR rates were analysed using chi-squared tests. Altogether, 3316 cases (10 different tumour entities) were analysed. Overall, 32 different therapeutic approaches were identified. The most common were curettage combined with high-speed burr (n = 774; 23.3%) and high-speed burr only (n = 620; 18.7%). The LR rate for studies with a minimum follow-up of 24 months (n = 30; 51.7%) was 12.5% (185/1483), with the highest rate found in GCT (16.7%; 144/861). In comparison to a combination of curettage, any adjuvant and PMMA, the sole application of curettage and high-speed burr (p = 0.015) reduced the LR rate in GCT. The overall complication rate was 9.6% (263/2732), which was most commonly attributable to postoperative fracture (n = 68) and osteoarthritis of an adjacent joint during follow-up (n = 62). A variety of adjuvants treatment options are reported in the literature. However, the most important step remains to be thorough curettage, ideally combined with high-speed burring. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Cancers is the property of MDPI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Abstract:
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