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GIANT CELL TUMOR OF THE DISTAL RADIUS: FACTORS ASSOCIATED WITH LOCAL RECURRENCE.

William Bernardo Specht Rabuske1, Michelle Ghert2,3, Bruno Pereira Antunes1

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Giant cell tumors of bone (GCTB) in the distal radius recur more often after intralesional curettage than resection. Improved surgical techniques are needed to lower recurrence rates.

Keywords:
Bone NeoplasmsCurettageDenosumabGiant Cell Tumor of BoneGiant Cell TumorsRecurrence

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Area of Science:

  • Orthopedic Oncology
  • Musculoskeletal Tumor Surgery
  • Bone Tumor Research

Background:

  • Giant cell tumors of bone (GCTB) are typically benign but can exhibit aggressive local behavior.
  • The distal radius is a common site for GCTB, posing challenges for limb salvage surgery.
  • Understanding recurrence patterns is crucial for optimizing treatment strategies.

Purpose of the Study:

  • To evaluate patient and tumor characteristics in distal radius GCTB.
  • To compare local recurrence rates based on different surgical treatment modalities.
  • To identify factors influencing treatment outcomes for GCTB of the distal radius.

Main Methods:

  • Retrospective review of 74 cases of distal radius GCTB from Brazilian institutions (1989-2021).
  • Data collected from medical records, including demographics, clinical presentation, and treatment type.
  • Primary outcome assessed was the local recurrence rate.

Main Results:

  • The mean age at diagnosis was 32.6 years, with a slight female predominance.
  • Local recurrence rate was 25.7% overall, significantly higher with intralesional curettage (35.1%) versus en bloc resection (16.2%).
  • Pathological fractures occurred in 15.7% and pulmonary metastasis in 1.4% of patients.

Conclusions:

  • Intralesional curettage is associated with a substantially higher risk of local recurrence for distal radius GCTB.
  • Standardized surgical protocols and advanced techniques are essential for improving outcomes.
  • Further research should focus on minimizing recurrence and enhancing functional results for these patients.