Recurrence and Risk Factors of Giant Cell Tumors in Hand Bones: A Systematic Review

Area of Science:

• Orthopedic Oncology
• Surgical Pathology
• Hand Surgery

Background:

• Giant cell tumor of bone (GCTB) is a locally aggressive neoplasm affecting hand bones.
• GCTB management is challenging due to variable recurrence rates and rare pulmonary metastasis.
• Understanding recurrence patterns and risk factors is crucial for effective GCTB treatment.

Purpose of the Study:

• To systematically review and delineate recurrence rates of GCTB in the hand.
• To identify significant risk factors associated with GCTB recurrence after surgical intervention.
• To inform surgical strategies and improve patient outcomes for GCTB in the hand.

Main Methods:

• Systematic literature search conducted in April 2024 (PubMed, TDNet) following PRISMA guidelines.
• Inclusion of cohort and case-control studies for recurrence rates; case reports/series for risk factors.
• Statistical analysis including descriptive statistics, chi-squared tests, and logistic regression.

Main Results:

• Overall recurrence rate of 19.57% observed across 13 studies (244 patients).
• Curettage demonstrated higher recurrence rates compared to alternative surgical techniques.
• Limited range of motion (ROM) emerged as a significant protective factor against recurrence.

Conclusions:

• High recurrence rates linked to curettage necessitate exploration of alternative surgical approaches for GCTB in the hand.
• Limited ROM as a protective factor emphasizes the importance of preoperative assessment for optimizing surgical plans.
• Findings support tailored surgical management to enhance outcomes and potentially reduce GCTB recurrence.