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

Abstract

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. 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. 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). 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.