Objective To discuss the surgical selection and effectiveness for patients with recurrent giant cell tumor of bone. Methods Between February 1988 and June 2007, 79 patients with recurrent giant cell tumor of bone were treated. There were 42 males and 37 females, with a mean age of 33.1 years (range, 15-72 years). In primary surgery, 76 patients underwent intralesional curettage, and the other 3 patients underwent resection; the recurrence time was 2-176 months after primary surgery. The locations of tumor were upper extremities in 14 cases and lower extremities in 65 cases. According to Companacci grade, 1 case was at grade I, 33 cases at grade II, and 45 cases at grade III before primary surgery. In secondary operation, 37 patients underwent intralesional curettage and bone grafting combined with adjuvant inactivated, and 42 patients underwent wide resection. Results Bone allograft immune rejection occurred in 2 cases, which led to poor healing; primary healing of incision was obtained in the other patients. The patients were followed up 68 months on average (range, 18-221 months). Recurrence occurred in 12 patients at 6-32 months after operation. The re-recurrence rate was 24.3% (9/37) in cases of intralesional curettage and bone grafting combined with adjuvant inactivated, and they were given the wide resection. The re-recurrence rate was 7.1% (3/42) in cases of wide resection and they were amputated. There was significant difference in the re-recurrence rate between the intralesional curettage and the wide resection (χ2=4.508, P=0.034). No recurrence was observed during 3-year follow-up among re-recurrence patients. Conclusion For benign recurrent giant cell tumor of bone, intralesional curettage and bone grafting combined with adjunctive therapy could get an acceptable effectiveness, however, it has higher local recurrence than wide resection. For large tumor and recurrent malignant giant cell tumor of bone, wide resection is recommended.
【Abstract】ObjectiveTo review the relationship between T helper cell 1/T helper cell 2 （Th1/Th2） shift and tumor recurrence. MethodsLiteratures on Th1/Th2 shift and tumor recurrence were collected and reviewed. ResultsTh1/Th2 shift can be detected in the host after therapy of the tumor. Tumor cells escape from host immune surveillance by altering Th1/Th2, which could lead to tumor recurrence. ConclusionTh1/Th2 shift is related to tumor recurrence after therapy. Impelling the reverse of Th2 to Th1 and renewing the balance of T helper cells come out to be a new way for tumor therapy.
ObjectiveTo explore the level of hope of patients with tumor recurrence and its affecting factors. MethodsPatients with tumor recurrence admitted in West China Hospital from March 2014 to March 2015 were included in this study. Questionnaire survey was conducted to collect the general information of the patients and the information on their coping style, level of hope and social support. The structural equation model was used to analyze the factors that affect the level of hope in patients with tumor recurrence. ResultsA total of 431 patients were included. The average score of hope in patients with tumor recurrence was 32.88±5.83. Among these patients, 27 (6.26%) had low level of hope, 277 (64.27%) had medium level of hope and 127 (29.47%) had high level of hope. The result of univariate analysis showed that, the level of hope in different genders, marital status, education levels, income levels and types of tumors had significant differences (all P values＜0.05). The result of structural equation model showed that gender (r=-0.322, P<0.001), marital status (r=-0.243, P<0.001), education level (r=-0.219, P<0.001), income (r=0.116, P=0.021) and coping style (r=0.182, P=0.029) had direct effect on the level of hope in patients with tumor recurrence. Social support (r=0.255, P=0.027) and income (r=0.224, P=0.019) could indirectly affect patients’ coping style and therefore the level of hope. ConclusionMost patients with tumor recurrence have medium to high level of hope. Gender, marital status, education level, income and coping style have influence on the level of hope. More attention should be given to patients with low level of hope, and measures should be taken to improve the level of hope basing on the individual situations of patients with tumor recurrence.
ObjectiveTo explore the correlation between the level of hope and coping style in patients with tumor recurrence. MethodsPatients with tumor recurrence admitted to West China Hospital between March 2014 and March 2015 were enrolled as the research subjects. Questionnaire survey was used to collect general information of patients and their level of hope and coping style. ResultsFour hundred and thirty-one patients were enrolled in the study. The score of hope in patients with tumor recurrence was 32.88±5.83. Out of 431 patients, 27 (6.26%) had low level of hope, 277 (64.27%) medium level of hope and 127 (29.47%) high level of hope. Multivariate analysis showed that the coping styles and income could enhance the level of hope, whereas being female, poor marital status, low educational level and long term of complete remission could suppress the level of hope in patients with tumor recurrence. Various coping styles were adopted by patients to cope with the tumor recurrence. Amongst all coping styles, optimism was adopted most frequently by patients, which had the highest score 2.94±0.44. The other coping styles adopted by patients ranked from high to low were conservation 2.88±0.53, self-reliance 2.75±0.56, confrontation 2.73±0.55, fatalism 2.45±0.66, support 2.41±0.52, escape 2.15±0.42 and emotion 2.12±0.59, respectively. The level of hope had a positive correlation with the overall score of coping styles (r=0.112), as well as optimism (r=0.170), confrontation (r=0.166) and self-reliance (r=0.210) (P < 0.05). However, the study showed that the level of hope had no correlation with emotion, escape, conservation, support and fatalism. ConclusionsMost of the patients with tumor recurrence have medium and high level of hope. The coping styles of optimism, confrontation and self-reliance can enhance the level of hope in patients with tumor recurrence. Patients should be encouraged and guided by medical staff to adopt the above-mentioned coping styles to enhance the level of hope, through which to improve the quality of life of the patients with tumor recurrence.