Epidemiologic Characteristics, Clinical Behavior, and Outcome of the Giant Cell Tumor of the Bone: A Retrospective Single-center Study

Document Type: RESEARCH PAPER

Authors

Bone and Joint Reconstruction Research Center, Shafa Ortopaedic Hospital, Iran University of Medical Science, Tehran, Iran

Abstract

Background: Giant cell tumor of bone (GCTB) is a locally aggressive lesion with an unpredictable behavior. Herein,
the aim of this study was to evaluate the epidemiological characteristics, as well as clinical and functional outcomes of
GCTB in a relatively large series of patients.
Methods: Patients with the diagnosis of GCTB were included in this retrospective study. Whenever the preservation
of the articular surface was possible, surgical options included extended curettage; otherwise, wide resection was
implemented. In case of extended curettage, the cavity was filled with cement or bone graft. In addition, the functional
and oncologic outcomes of these surgical strategies were compared. The functional outcome of the patients was
assessed using the Musculoskeletal Tumor Society (MSTS) scoring system.
Results: A total of 120 GCTB patients, including 55 males (45.8%) and 65 females (54.2%), were evaluated. The
three involved locations with highest frequency included distal femur (26%), distal radius (22%), and proximal tibia
(19%). At a mean follow-up of 125.5±49.2 months, two pulmonary metastases (1.6%) and 12 (10%) local recurrences
were observed. In addition, 6 out of 12 (50%) local recurrences occurred in distal radius (P=0.04). The recurrence rate
was significantly higher in extended curettage than in wide resection (P=0.05), and the same pattern was observed
for allograft, compared to cement filling (P=0.05). The mean MSTS scores for extended curettage and wide resection
were 94.7 and 89.1, respectively (P=0.04). Furthermore, the mean MSTS scores for bone graft filling and cement
augmentation were obtained as 96 and 93.1, respectively (P=0.07).
Conclusion: Based on the findings, wide resection of GCTB was associated with superior oncologic outcome, as well
as inferior functional outcome. In extended curettage, cement augmentation resulted in superior oncologic outcome
when compared with allograft filling.
Level of evidence: IV

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