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

Background: 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 ofGCTB in a relatively large series of patients.Methods: Patients with the diagnosis of GCTB were included in this retrospective study. Whenever the preservationof the articular surface was possible, surgical options included extended curettage; otherwise, wide resection wasimplemented. In case of extended curettage, the cavity was filled with cement or bone graft. In addition, the functionaland oncologic outcomes of these surgical strategies were compared. The functional outcome of the patients wasassessed using the Musculoskeletal Tumor Society (MSTS) scoring system.Results: A total of 120 GCTB patients, including 55 males (45.8%) and 65 females (54.2%), were evaluated. Thethree 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 recurrenceswere observed. In addition, 6 out of 12 (50%) local recurrences occurred in distal radius (P=0.04). The recurrence ratewas significantly higher in extended curettage than in wide resection (P=0.05), and the same pattern was observedfor allograft, compared to cement filling (P=0.05). The mean MSTS scores for extended curettage and wide resectionwere 94.7 and 89.1, respectively (P=0.04). Furthermore, the mean MSTS scores for bone graft filling and cementaugmentation were obtained as 96 and 93.1, respectively (P=0.07).Conclusion: Based on the findings, wide resection of GCTB was associated with superior oncologic outcome, as wellas inferior functional outcome. In extended curettage, cement augmentation resulted in superior oncologic outcomewhen compared with allograft filling.Level of evidence: IV

Keywords:

epidemiologic characteristics , Functional outcome , Giant cell tumor of bone , oncologic outcome