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GIANT CELL TUMOR OF BONE: A MULTICENTER EPIDEMIOLOGICAL STUDY IN BRAZIL
Ricardo Gehrke Becker1,2, Carlos Roberto Galia1, Julie Francine Cerutti Santos Pestilho2
1Hospital de Clínicas de Porto Alegre (HCPA), Department of Orthopedics and Trauma, Porto Alegre, RS, Brazil.
Acta Ortopedica Brasileira
|March 27, 2024
Summary
Giant cell tumor of bone (GCTB) recurrence and metastasis rates are significant. Regional disparities in Brazil correlate with worse outcomes, indicating a need for improved orthopedic oncology care in underserved areas.
Area of Science:
- Orthopedic Oncology
- Bone Tumors
- Public Health
Background:
- Giant cell tumor of bone (GCTB) commonly affects young adults, impacting bone strength and joint function.
- Surgical intervention is the primary treatment for GCTB, but local recurrence rates remain a significant concern.
- Regional variations in healthcare access and quality may influence GCTB patient outcomes.
Purpose of the Study:
- To analyze patient profiles, treatment strategies, and outcomes for GCTB across different regions in Brazil.
- To identify regional disparities in GCTB management and their impact on recurrence, metastasis, and pathological fractures.
- To highlight the need for enhanced orthopedic oncology services in economically challenged regions of Brazil.
Main Methods:
- Retrospective analysis of 643 GCTB patients from 16 Brazilian centers (1989-2021).
- Assessment of local recurrence, pulmonary metastasis, and pathological fracture rates.
- Evaluation of regional differences in tumor presentation, treatment approaches, and surgical delays.
Main Results:
- Overall local recurrence rate was 18.2%, with 5.1% developing pulmonary metastases and 14.3% experiencing pathological fractures.
- Higher incidences of pulmonary metastases (12.1%) and advanced tumors (Campanacci III, 88.9%) were observed in the North and Northeast regions.
- The North region showed increased rates of pathological fractures (33.3%), extensive resections (61.1%), and amputations (27.8%), alongside longer surgical delays compared to the South and Southeast.
Conclusions:
- Regional disparities in Brazil contribute to varied GCTB outcomes, with disadvantaged areas facing poorer prognoses.
- Findings align with international data, emphasizing the critical need for equitable access to specialized orthopedic oncology care.
- Addressing socioeconomic and structural challenges in underserved regions is crucial for improving GCTB patient management and outcomes.
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