The Epidemiologic Characteristics, Clinical Behavior and Outcome of the Giant Cell Tumor of Bone: a Retrospective Single-Center Study

Abstract Objects:Giant cell tumor of bone (GCTB) isa locally aggressive lesion with unpredictable behavior. Here, we aim to evaluate the epidemiological characteristics, clinical and functional outcome of GCTB in a relatively large series of patients. Methods:Patients with the diagnosis of GCTB were included in this retrospective study.Surgical options included extended curettage whenever preservation of the articular surface was possibleand wide resection otherwise. Forextended curettage, the cavity was filled with cement or bone graft. The functional and oncologic outcome of these surgical strategies was compared.The functional outcome of patients was assessed using the Musculoskeletal Tumor Society (MSTS) scoring system. Results:A total of 120 GCTB patients, including55 males (45.8%) and 65 females (54.2%) were evaluated. Distal femur (26%), distal radius (22%), and proximal tibia (19%) were the most three involved locations. At a mean follow-up of 125.5±49.2 months, two pulmonary metastasis (1.6%) and 12 (10%) local recurrences were observed. Six out of 12 (50%) local recurrences occurred in distal radius (p=0.04). The recurrence rate was significantly higher in extended curettage than wide resection (p=0.05) and in allograft compared to cement filling (p=0.05). The mean MSTS score was 94.7 for extended curettage and 89.1 for wide resection (p=0.04). The mean MSTS was 96 for bone graft filling and 93.1 for cement augmentation (p=0.07). Conclusion:Wide resection of GCTB is associated with superior oncologic outcome and inferior functional outcome. In extended curettage, cement augmentation results in superior oncologic outcome when compared with allograft filling.