Giant cell tumors combined with secondary aneurysmal bone cysts are more likely to develop postoperative recurrence: A retrospective study of 256 cases

Abstract

Purpose The epidemiology and clinicopathology of aneurysmal bone cysts (ABCs) secondary to giant cell tumors of bone (GCTBs) have been well documented in the previous literature. However, reports on whether secondary ABCs could affect the postoperative recurrence of GCTBs are rare. This study analyzed the effects of secondary ABCs and other relevant clinical factors on the postoperative recurrence of GCTBs of the extremities. Methods We retrospectively analyzed 256 cases of GCTBs of the extremities that were treated surgically at our institution. Among them, there were 60 patients diagnosed with GCTBs combined with secondary ABCs and 196 patients diagnosed with simple GCTBs. Intralesional curettage and tumor resection were performed in 136 and 120 cases, respectively. Univariate analysis, Kaplan‐Meier survival analysis, and multivariate regression analysis were used to assess the factors for postoperative recurrence. The follow‐up period was at least 24 months. Results The total postoperative recurrence rate was 32%. The recurrence rate in the secondary ABCs group was significantly higher than that in the simple GCTBs group (53.3% vs 25.5%, P < 0.05). Curettage was associated with a higher recurrence rate than tumor resection (42.5% vs 20%, P < 0.05). Kaplan‐Meier survival analysis showed that patients with GCTBs combined with secondary ABCs and who were treated by intralesional curettage had a decreased disease‐free survival rate. The hazard ratio was 2.18 (95% confidence interval [CI], 1.15‐4.13) for the group of GCTB combined with ABCs ( P = 0.01) and 1.97 (95% CI, 1.22‐7.50) for the curettage group ( P = 0.01), respectively. Multivariate regression analysis revealed that the presence of secondary ABCs and curettage were independent factors for recurrence of GCTBs. Conclusion According to the results of this study, the presence of secondary ABCs is a potential risk factor for postoperative relapse of GCTBs.

Current Concepts in the Treatment of Giant Cell Tumors of Bone

“…The reason for the high recurrence rate of GCTB in the hand and foot is that the cortical window needs to be small as the bones in this location are smaller, making it difficult to perform aggressive curettage [59]. The presence of a fluid-fluid interface suggests a secondary aneurysmal bone cyst, while the presence of a secondary aneurysmal bone cyst increases the local recurrence rate after curettage [62,63]. Tang et al reported that secondary aneurysmal bone cysts were found in 60 (23%) of 256 patients with GCTB in the extremities; the local recurrence rate was 53% in the group with secondary aneurysmal bone cysts, while it was 26% in the group without secondary aneurysmal bone cysts (p < 0.05) [62].…”

“…The presence of a fluid-fluid interface suggests a secondary aneurysmal bone cyst, while the presence of a secondary aneurysmal bone cyst increases the local recurrence rate after curettage [62,63]. Tang et al reported that secondary aneurysmal bone cysts were found in 60 (23%) of 256 patients with GCTB in the extremities; the local recurrence rate was 53% in the group with secondary aneurysmal bone cysts, while it was 26% in the group without secondary aneurysmal bone cysts (p < 0.05) [62]. The reason for the higher risk of local recurrence is that secondary aneurysmal bone cysts cause more bleeding and inadequate curettage [62].…”

Single-Cell RNA Sequencing Reveals the Migration of Osteoclasts in Giant Cell Tumor of Bone

“…The existing literature on GCTB is mostly comprised of genetic and genomic studies and clinical case reports ( 68 , 69 ). These studies provide a basis for understanding the current treatment strategies for GCTB.…”

Oncology and functional prognosis are both vital in the surgical treatment of RGCTs around the knee joint

“…Although rigorous preoperative design, sophisticated surgical techniques, and standardized postoperative follow-up can maximize the benefit of patients, the risk of recurrence of RGCT remains [35,36]. The therapeutic regimen for recurrence post-operation can be referred to the initial recurrence, which is determined based on the specific conditions of the initial treatment, pathological characteristics, invasive extent, and tumor comorbidity after recurrence.…”