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Giant cell tumor of long bone: a Canadian Sarcoma Group study
Robert E Turcotte1, Jay S Wunder, Marc H Isler
1University of Montreal, Montreal, Quebec, Canada,
Clinical Orthopaedics and Related Research
|April 16, 2002
Summary
Giant cell tumor of bone recurrence rates were not affected by filling materials or adjuvants after curettage. Pathologic fractures negatively impacted patient function and health status scores.
Area of Science:
- Orthopedic Surgery
- Oncology
- Bone Tumors
Background:
- Giant cell tumor of bone (GCTB) is a primary bone tumor typically occurring in skeletally mature individuals.
- Treatment of GCTB often involves surgical intervention, with curettage and adjuvant therapies being common approaches.
Purpose of the Study:
- To investigate the impact of various filling materials and adjuvant therapies on the recurrence rates of giant cell tumors of bone treated with curettage.
- To assess the influence of treatment modalities and pathologic fractures on patient-reported outcomes.
Main Methods:
- A multicentric retrospective study involving 186 patients with giant cell tumors of bone.
- Data collected included patient demographics, tumor characteristics (grade, location, primary vs. recurrence), treatment methods (curettage, resection, filling materials, adjuvants), and functional outcomes.
- Statistical analysis was performed to evaluate recurrence rates and functional scores (Musculoskeletal Tumor Society rating, Short Form-36, Toronto Extremity Salvage Score).
Main Results:
- The overall recurrence rate for GCTB was 17%, with 18% recurrence after curettage and 16% after resection.
- Primary tumors treated with curettage had a 10% recurrence rate, while recurrent lesions treated with curettage had a 35% recurrence rate.
- Neither the type of filling material (cement, bone graft) nor the adjuvant used (phenol, liquid nitrogen) showed a statistically significant impact on recurrence risk.
- Pathologic fractures were associated with significantly lower Musculoskeletal Tumor Society scores and bodily pain scores on the Short Form-36.
Conclusions:
- The choice of filling material or adjuvant therapy does not appear to influence the recurrence risk of giant cell tumors of bone when treated with curettage.
- Pathologic fractures are a significant negative prognostic factor, impacting functional outcomes and pain levels in GCTB patients.
- Further research may be warranted to explore optimal management strategies for recurrent GCTB and the prevention of pathologic fractures.