A retrospective analysis of surgical treatment for giant cell tumor in sacrum:a single-center study

XUE Ying-sen; WANG Zhen; GUO Zheng; ZHANG Yu-shen; FAN Hong-bin

doi:10.3969/j.issn.2095-252X.2019.01.003

Abstract：Objective To investigate the surgical treatment for giant cell tumors in sacrum and to evaluate the operation method, local recurrence rate and complications.Methods A retrospective study of 27 patients diagnosed with giant cell tumors in sacrum had been conducted from 1990 to 2017.There were 10 males and 17 females with an average age of 34 years (range:19-50 years).En bloc resection was carried out in 2 patients with tumors below S3level (A).Intralesional resection was carried out in 8 patients with tumors S2 and below (B), 12 patients with tumors S1 and below (C) and 3 patients with tumors S1 and sacroiliac involvement (D).The average follow-up period was58 months (range:18-132 months).Five cases were lost to follow-up.Twenty-two cases were adopted to this study.Results There were 6 local recurrences (27％) who received initial operation.Two patients received a second surgery with no local recurrence.Four cases received conservative treatment, such as embolization and Dino single resistance.One case appeared lung metastasis.All cases had no significant neurological loss after treatment.Neurological symptoms were common and brief.Symptoms included brief bowel or bladder incontinence and perineal hypoesthesia.Five patients had deep wound effusion, 1 case had intestinal fistula, and 1 case had internal fixation breakage.Conclusions En bloc resection is a better surgical treatment for patients with tumors below S3 level (A).The tumors can be locally controlled and neurological function can be preserved after isintralesional resection for patients with tumors above S3 level (B/C/D).