Giant cell tumor of the bone: Both common and rare clinical aspects. Single institute experience

Abstract

Objective Giant cell tumor of the bone remains one of the popular subjects for its biologically and clinically unpredictable behaviors. This paper presents the long-term outcomes, common and also rare clinical features of the patients with giant cell tumors of the bone.Methods Sixty-eight patients were included in the study between January 1996 and December 2022. Demographic data of the patients were extracted from the hospital database. The radiological assessment was conducted using the Picture Archive Communication System. Information on local adjuvants, filling material of the residual space, systemic administration of Denosumab, and presence of metastasis and local recurrences were enrolled from the patient files. The tumors were classified according to Campanacci classification.Results The most frequent site for the tumor was the knee (59.3%). Among the tumors 22.1% were grade-1, 39.7% were grade-2 and 38.2% were grade-3. The mean tumor volume was 182.8 cm³. Sixteen (23.5%) patients had received Denosumab as a systemic treatment. Fifty-five patients were treated with curettage, twelve with resection, and one with amputation. Chemical local adjuvants were used in 42 patients. The tumor bed was filled with cement in 38 patients, bone graft in 12, and remained unfilled in 5 patients. The rate of recurrence was 35.3%. Six patients experienced multiple recurrences. The rate of metastasis was 11.8%, and malignant giant cell tumor of the bone was diagnosed in two (2.9%) patients. Age, gender, tumor grade, size, and location, neo-adjuvant denosumab treatment, the use or type of local adjuvants, and the presence of tumor thrombus were not found to be related to recurrence or metastasis rates; however, marginal resection as initial surgery was found to be significantly related to decreased recurrence rates.Conclusion Metastasis and local recurrence rates were not affected by the preoperative Campanacci grade, neo-adjuvant denosumab administration, type of local adjuvant, filling material, or tumor volume. However, decreased recurrence rate was found to be related to the patients underwent resection.