Our tactics in diagnostics and treatment of patients with giant-cell tumors of bones

Purpose. To analyze the treatment results in patients with bone giant-cell tumors (GCT), evaluate the role of immunohistochemical reactions using the index of Ki-67 proliferative activity and a new device for bone tumor biopsies. Materials and Methods. The diagnostic tactics using a device for taking bone tumor biopsies and the index of proliferative activity in immunohistochemical investigations developed by the personnel of the Department of traumatology, orthopedics and extreme surgery of the Samara State Medical University together with the personnel of the Samara Regional Clinical Oncologic Center since 2009. A technique of bone tissue preparation for surgical treatment of benign skeletal tumors, a new technique for plasty of bone tissue defect in the meta-epiphyseal zone of long tubular bones for the similar treatment implemented during treatment of patients. The presented technique of bone tissue preparing with plasma used in surgical treatment of 29 patients with skeletal bone giant-cell tumor and follow-up periods up to 4 years. Results. Necrosis zone obtaining during resection zone preparing with argon plasma flow allowed to maintain mineral structures by their composition and form with the loss of all cellular elements including tumor ones being a cause of recurrences. Recurrences with soft-tissue component revealed in two cases within the periods below 6 months, and limb amputations performed due to this. Conclusion. The experimental and clinical data obtained allow to use preparing the zone of bone tissue resection with a flow of low-temperature plasma in order to obtain the zone of necrosis which can contribute to increase the effectiveness of surgical treatment in patients with skeletal bone giant-cell tumors of benign variant.