Treatment of local recurrences of giant cell tumour in long bones after curettage and cementing

Abstract

We retrospectively studied local recurrence of giant cell tumour in long bones following treatment with curettage and cementing in 137 patients. The median follow-up time was 60 months (3 to 166). A total of 19 patients (14%) had at least one local recurrence, the first was diagnosed at a median of 17 months (3 to 29) after treatment of the primary tumour. There were 13 patients with a total of 15 local recurrences who were successfully treated by further curettage and cementing. Two patients with a second local recurrence were consequently treated twice. At the last follow-up, at a median of 53 months (3 to 128) after the most recent operation, all patients were free from disease and had good function. We concluded that local recurrence of giant cell tumour after curettage and cementing in long bones can generally be successfully treated with further curettage and cementing, with only a minor risk of increased morbidity. This suggests that more extensive surgery for the primary tumour in an attempt to obtain wide margins is not the method of choice, since it leaves the patient with higher morbidity with no significant gain with respect to cure of the disease.

Cement is recommended in intralesional surgery of giant cell tumors: A Scandinavian Sarcoma Group study of 294 patients followed for a median time of 5 years

“…As recurrences can usually be treated successfully (Vult von Steyern et al 2006), intralesional surgery is preferable. In intralesional surgery, we strongly recommend the use of cement.…”

The prognostic factors of recurrent GCT: a cooperative study by the Eastern Asian Musculoskeletal Oncology Group

“…Vult von Steyern et al 19 reported that 13 patients with a total of 15 local recurrences were successfully treated by further curettage and cementation. Two of the patients with a second local recurrence were consequently treated twice.…”

“…The incidence of local recurrence, lung metastasis after treatment of primary GCT, and malignant transformation have been described 1,2,6,7,[13][14][15][16] . However, the clinical behavior of recurrent GCT, treatment strategy, and the factors affecting the clinical outcome has not been fully ellucidated [17][18][19][20][21][22] . In this multi-center study by the Eastern Asian Musculoskeletal Oncology Group (EAMOG), we retrospectively investigate the prognosis for 110 patients with recurrent GCT of bone in the extremities, and we examine the potential factors affecting the clinical outcome of these patients.…”

Is Intralesional Treatment of Giant Cell Tumor of the Distal Radius Comparable to Resection With Respect to Local Control and Functional Outcome?

“…The distal radius is the third most common location for giant cell tumor of bone after the distal femur and proximal tibia, accounting for approximately 10% to 15% of cases [10,27,29,30,40]. Numerous authors have identified the distal radius as being particularly prone to recurrence [2,8,10,13,16,21,30,[36][37][38][39].…”

“…Intralesional excision preserves the joint but even if used in combination with surgical adjuvants has a reasonably high risk of local recurrence [18,28,30,36]. Variables reported to influence local recurrence include the Campanacci grade [2,18,22,27,30,34], pathologic fracture [27,30,40], tumor location [2,13,16,27,36,39,40], type of adjuvant used [2, 7, 10-12, 16, 17, 25, 27, 30, 32, 35, 36, 38], and treatment of a primary versus a recurrent tumor [2,27,38].…”