Risk factors for local recurrence of giant cell tumor of bone of the extremities: a retrospective study

Abstract

Background:Although considered as a benign tumor, giant cell tumor of bone (GCTB) has an aggressive biological behavior with high tendency for local recurrence (LR). The most commonly used method of treatment of GCTB is intralesional curettage augmented by various types of local adjuvants. The aim of this study was to evaluate the rate of recurrence of GCTB after surgical treatment to detect the risk factors that may influence the rate of LR. Methods:Fifty-two cases of GCTB that had been treated in a university hospital musculoskeletal oncology unit, between 2012 and 2017 were retrospectively reviewed after minimal follow-up of 4 yr and risk factors of LR were determined. Results:All LRs occurred within the first 3 yr (4 to 31 mo). Curettage was used to manage 34 patient cases, from which 11 patients (32.4%) showed LR. Only one patient (5.6%) of the 18 wide local excision patients developed recurrence. The highest recurrence rate was found among the lesions of the proximal femur. Neither the tumor volume nor the pathological grade had a significant impact on the rate of LR. The presence of soft-tissue invasion, occurrence of pathological fracture at presentation and using curettage as a method of treatment were associated with significantly higher rate of LR. Conclusions:Lesions in the proximal femur, occurrence of pathological fracture at presentation, soft-tissue invasion, and curettage as management option were found to be associated with an increased risk of LR of GCTB.

Oncology

“…In this study from Mansoura (Egypt) , the authors aimed to evaluate the recurrence of GCTB to understand the risk factors for recurrence. 9 This is a retrospective study of a decent number (n = 52) of patients and was carried out to evaluate the influence of different factors related to patient data, lesion criteria, and surgical treatment options on the timing and frequency of LR of GCTB of long bones to four years. The authors hypothesized that these risk factors could help in early detection of LR in high-risk patients or dictate certain treatment modalities in these patients.…”

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“…Specific findings may include a new kyphotic deformity, swelling, bony tenderness, and areas of erythema. 9 A complete neurological examination is mandatory.…”