Giant cell tumor of the bone: an evaluation of prognostic factors associated with local recurrence and a comparison with the current literature

Abstract

Aim: Results of the surgical and medical treatments of giant cell tumor of the bone (GCT) in terms of local recurrence and prognostic factors associated with local recurrence are evaluated in this study. Material and Method: Patients treated with either surgical or medical methods for GCT between 2011 and 2021 were retrospectively evaluated. Gender and age of the patients, localization of tumors, the existence of pathological fractures, grade of the tumor, soft tissue expansion, and resection types were evaluated. Postoperative local recurrence and metastasis were analyzed, and the risk factors associated with local recurrence were determined. Results: The mean age of the 117 patients (51 female and 66 male) was 36.1±9.3 years. The mean follow-up was 71.2±48.3 months. Forty patients were Grade I, 56 were Grade II, and 21 were Grade 3, according to the Campanacci Grading System. Soft tissue expansion was present in 21 (17.9%) patients. 59.8% of the patients were undergone intralesional curettage, 32.4% of the patients were treated with marginal or wide local excision combined with adjuvant therapy with liquid nitrogen and poly-methyl methacrylate (PMMA) application, and 5.9% of the patients have treated with en bloc wide resection and reconstruction or arthrodesis. Two patients suffering from sacral involvement were treated with radiotherapy. There was local recurrence after surgery in 19 (16.2%) of the patients. Conclusion: Local recurrence is an important cause of morbidity in the treatment of GCT, which is a benign but aggressive tumor of the bone. In this study, in which we investigated the causes of local recurrence, Campanacci Grade and soft tissue expansion were found to be associated with the development of local recurrence.