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Review
. 2016 Dec;6(8):798-803.
doi: 10.1055/s-0036-1579746. Epub 2016 Mar 7.

Systematic Review and Meta-analysis of En Bloc Vertebrectomy Compared with Intralesional Resection for Giant Cell Tumors of the Mobile Spine

Panya Luksanapruksa  1 , Jacob M Buchowski  2 , Weerasak Singhatanadgige  3 , David B Bumpass  4
Affiliations
Review

Systematic Review and Meta-analysis of En Bloc Vertebrectomy Compared with Intralesional Resection for Giant Cell Tumors of the Mobile Spine

Panya Luksanapruksa et al. Global Spine J. 2016 Dec.

Abstract

Study Design Systematic review and meta-analysis. Objective To compare the recurrence and perioperative complication rate of en bloc vertebrectomy (EV) and intralesional resection (IR) in the giant cell tumor of the mobile spine (SGCT). Methods We systematically searched publications in the PubMed and Embase databases for reports of SGCTs, excluding the sacrum. Two reviewers independently assessed all publications. A meta-analysis was performed using local recurrence and postoperative complications as the primary outcomes of interest. Results There were four articles reporting recurrence and two articles reporting postoperative complications. All included articles were case series. In all, 91 patients were included; 49 were treated with IR and 42 were treated with EV. Local recurrence rates were 36.7 and 9.5% in the IR and EV groups, respectively. Rates of postoperative complications were 36.4% with IR and 11.1% with EV. Overall, patients treated with EV not only had a lower recurrence rate (relative risk [RR] 0.22; 95% confidence interval [CI] 0.09 to 0.52) but also had a lower postoperative complication rate (RR 0.34; 95% CI 0.07 to 1.52) compared with IR. Conclusions Based on the limited data obtained from systematic review, SGCT patients treated with EV had a lower recurrence rate and fewer postoperative complications than those treated with IR.

Keywords: en bloc vertebrectomy; giant cell tumor; intralesional resection; meta-analysis; mobile spine; postoperative complications; recurrence.

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Figures

Fig. 1
Fig. 1
Flow diagram demonstrating study search results.
Fig. 2
Fig. 2
Forest plot to illustrate risk ratio in recurrence between vertebrectomy and intralesional resection. Abbreviations: CI, confidence interval; M-H, Mantels-Haenszel methods.
Fig. 3
Fig. 3
Forest plot to illustrate risk ratio in postoperative complications between en bloc vertebrectomy and intralesional resection. Abbreviations: CI, confidence interval; M-H, Mantels-Haenszel methods.
Fig. 4
Fig. 4
Funnel plot for the publication bias test of the four eligible studies.
See this image and copyright information in PMC

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