American journal of translational research · 2026
Efficacy of microwave in situ ablation combined with intralesional curettage for locally aggressive benign bone tumors based on MSTS scores, bone healing time, and recurrence rate.
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Liu Libing, Li Tingdong, Li Jing, Gan Yuling, Qi Jianghua, Xue Jinxu
Аннотация
OBJECTIVE: To compare the clinical efficacy of microwave in situ ablation (MWA) combined with intralesional curettage versus intralesional curettage alone for locally aggressive benign bone tumors, including giant cell tumor of bone, aneurysmal bone cyst, and chondroblastoma, with a focus on local recurrence control, limb function, and bone healing.
METHODS: This retrospective cohort study included 284 patients who were divided into a combined group (MWA plus curettage, n=156) and a control group (curettage alone, n=128). Baseline characteristics, perioperative outcomes, complications, local recurrence, bone healing status, and Musculoskeletal Tumor Society (MSTS) scores were compared. Recurrence-free survival (RFS) was analyzed using Kaplan-Meier method, and independent risk factors were evaluated using Cox regression analysis. Subgroup analyses were performed based on pathologic type and lesion size.
RESULTS: The combined group had a significantly lower local recurrence rate than the control group (7.1% vs. 18.0%, P=0.008) and an improved RFS HR=0.38, 95% CI: 0.19-0.79). MSTS scores were significantly higher in the combined group at all postoperative time points (all P>0.05). Bone healing time was shorter in the combined group (4.3±1.5 vs. 5.0±1.5 months, P<0.001), with a lower rate of delayed union (5.8% vs. 18.8%, P=0.001). Multivariable analysis identified MWA as an independent protective factor (HR=0.25, P<0.001), while soft tissue involvement, lesion diameter >6 cm, and extensive cortical destruction were independent risk factors. Subgroup analyses showed consistent benefits in larger lesions.
CONCLUSION: MWA combined with intralesional curettage significantly reduces local recurrence, improves limb function, and accelerates bone healing compared to curettage alone. It represents a safe and effective limb-salvage strategy for locally aggressive benign bone tumors.
METHODS: This retrospective cohort study included 284 patients who were divided into a combined group (MWA plus curettage, n=156) and a control group (curettage alone, n=128). Baseline characteristics, perioperative outcomes, complications, local recurrence, bone healing status, and Musculoskeletal Tumor Society (MSTS) scores were compared. Recurrence-free survival (RFS) was analyzed using Kaplan-Meier method, and independent risk factors were evaluated using Cox regression analysis. Subgroup analyses were performed based on pathologic type and lesion size.
RESULTS: The combined group had a significantly lower local recurrence rate than the control group (7.1% vs. 18.0%, P=0.008) and an improved RFS HR=0.38, 95% CI: 0.19-0.79). MSTS scores were significantly higher in the combined group at all postoperative time points (all P>0.05). Bone healing time was shorter in the combined group (4.3±1.5 vs. 5.0±1.5 months, P<0.001), with a lower rate of delayed union (5.8% vs. 18.8%, P=0.001). Multivariable analysis identified MWA as an independent protective factor (HR=0.25, P<0.001), while soft tissue involvement, lesion diameter >6 cm, and extensive cortical destruction were independent risk factors. Subgroup analyses showed consistent benefits in larger lesions.
CONCLUSION: MWA combined with intralesional curettage significantly reduces local recurrence, improves limb function, and accelerates bone healing compared to curettage alone. It represents a safe and effective limb-salvage strategy for locally aggressive benign bone tumors.