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Modeling Primary Bone Tumors and Bone Metastasis with Solid Tumor Graft Implantation into Bone
Published on: September 9, 2020
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Giant cell tumour of bone
Ahmed Aoude1, David Nikomarov2, Jonathan R Perera3
1Orthopedics Spine and Oncology, Montreal General Hospital, McGill University, Montreal, Canada.
The Bone & Joint Journal
|April 30, 2023
Summary
Giant cell tumour of bone (GCTB) treatment focuses on joint preservation. While curettage has a higher recurrence risk, most relapses can be re-treated, preserving joint function.
Area of Science:
- Orthopedic Surgery
- Oncology
- Bone Tumors
Background:
- Giant cell tumour of bone (GCTB) is a locally aggressive bone neoplasm.
- Joint salvage in GCTB treatment is challenging due to high local recurrence (LR) rates.
- Optimizing long-term function is crucial for young GCTB patients.
Purpose of the Study:
- To identify risk factors for tumour relapse after GCTB treatment.
- To evaluate the success of joint salvage procedures for GCTB.
- To compare local recurrence rates between curettage and en bloc resection.
Main Methods:
- Retrospective analysis of 354 consecutive GCTB patients undergoing joint salvage (curettage or resection).
- Exclusion of patients treated with denosumab.
- Analysis of patient, tumour, and treatment factors influencing local recurrence.
Main Results:
- Overall LR rate was 15% (53/354), with higher rates after curettage (18.4%) than resection (4.6%).
- Pathological fracture, Campanacci grade, soft-tissue extension, and tumour size did not significantly impact LR.
- Younger age (<30 years) and distal radius location predicted higher LR after curettage.
- 90% of local relapses after curettage were successfully re-treated with repeat joint salvage.
Conclusions:
- Aggressive curettage allows successful joint salvage in most GCTB cases, despite potential for local recurrence.
- Younger patients and those with distal radius GCTB treated with joint-sparing surgery require closer follow-up.
- Maximizing joint salvage is key to optimizing long-term function in GCTB patients.
