Managing Sacral Giant Cell Tumor with Surgery and Various Adjuvant Therapies

Background and purpose: There is no consensus regarding the appropriate treatment of sacral giant cell tumor (SGCT). This study is to compare oncological and neurological outcomes of SGCT managed by surgery and various adjunctive therapies.Methods: A total of 31 patients with SGCT were retrospectively studied. They were divided into two Groups. A: 13 patients underwent surgery plus SAE and radiotherapy; Group B: 18 patients underwent surgery plus one arterial embolization and denosumab. The postoperative functional outcomes, recurrence, mortality, and complications were compared.Results: The mean operation time (231±49min) and blood loss (3167±856mL) of group B were significantly less than those of group A (283±41min, 5054±689mL) (p<0.05). The average follow-up was 68.5 months. The neurologic function scores showed no significant difference. The recurrence rate of group B (11.2%) was much lower than that of group A (30.7%, p=0.17). The cumulative survival rate of group B was higher than that of group A (p=0.133).Conclusions: In comparison to other adjuvant therapies, one arterial embolization plus denosumab can reduce the intra-operative blood loss, shorten the operation time, and decrease the recurrence rate in patients with SGCT.