Retrospective analysis of risk factors for recurrence of giant cell tumor of bone in knee

Abstract

Objective To explore the clinical and radiological risk factors of postoperative recurrence in patients with giant cell tumor of bone in knee.Methods We retrospectively analysised 105 cases of giant cell bone tumor of bone in knee from six domestic bone tumor treatment units,including the clinical and radiological data from 36 cases of local post-operative recurrence and 69 non-recurrent cases.We analysised whether the clinical factors(gender,age,location,clinical scoring/grade and surgical procedures)and the radiological factors were in correlation with postoperative recurrence by univariate analysis.Then we integrated the statistically significant indicators into Logistic regression equation to determine the related risk factors for recurrence.Results The study group consisted of 105 cases,including 49 males and 56 females.And the average follow-up time was 45.6± 32.1 months.The recurrent group included 36 cases with average age of 35.64± 10.87 years old and average recurrence time of 18.9±6.5 months.The non-recurrent group included 69 cases with average age of 36.32± 13.82 years old.Univariate x2 analysis suggested that sharp edges or sclerosis of the lesion,cortical destructive interruption,soft tissue mass,Hu scoring and surgical procedures were associated with postoperative recurrence.Other clinical factors (gender,age,location,Campanacci grade) and some radiological factors (swelling,multilocular or osseous interval,cortical damage,pathological fracture,lesion reaching articular surface,bone marrow edema,cystic change) were not associated with postoperative recurrence.The multivariate Logistic regression analysis showed sharp edges or sclerosis of the lesion (p =0.048),soft tissue mass (P=0.041),Hu scoring (P=0.040) and surgical procedures (P=0.001) were closely related to the tumor postoperative recurrence.Conclusion The postoperative recurrence of giant cell tumor of bone in knee is affected by many factors.The radiological findings,including obscure edges of the lesion and soft tissue mass,are independent risk factors.Preoperative Hu scoring and surgical procedures are important factors affecting tumor recurrence. Key words: Knee joint; Giant cell tumor of bone; Recurrence; Risk factors