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

Abstract

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