Analysis of Local Recurrence of Giant Cell Tumor

Sang-Ho Cheon; Il-Hyung Park; Hwan-Seong Cho; Do-Hyung Kim

doi:10.5292/jkbjts.2010.16.2.51

Journal List > J Korean Bone Joint Tumor Soc > v.16(2) > 1051973

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Cheon, Park, Cho, and Kim: Analysis of Local Recurrence of Giant Cell Tumor

Original Article

J Korean Bone Joint Tumor Soc 2010;16(2):51-54.

Published online: 17 December 2010

DOI: https://doi.org/10.5292/jkbjts.2010.16.2.51

Analysis of Local Recurrence of Giant Cell Tumor

Sang-Ho Cheon, M.D., Il-Hyung Park, M.D., Hwan-Seong Cho, M.D., Do-Hyung Kim, M.D.

Department of Orthopedic Surgery, Kyungpook University College of Medicine, Daegu, Korea

Correspondence to: Il-Hyung Park, M.D. Department of Orthopedic Surgery, Kyungpook University College of Medicine, 2-50, Samduk-dong, Chung-gu, Daegu 700-721, Korea TEL: +82-53-420-5634 FAX: +82-53-422-6605 E-mail: ihpark@knu.ac.kr

Received 30 July 201027 September 2010 Accepted 20 October 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was aimed to evaluate the recurrence rate of a giant cell tumor (GCT) of the bone.

Materials and Methods

The medical records of fifty four patients who were diagnosed with a giant cell tumor of the bone between March 1980 and December 2008 were analysed retrospectively. Among 54 patients, 27 were men, remaining 27 were women with the mean age of 33.1 years (range, 13-67 years). The mean duration of followup was 67.1 months.

Results

Twenty-one patients (38.9%) had a local recurrence. The mean time to recurrence was 21.5 months (range, 2-59 months). The local recurrence rate of the upper extremities was higher than that of lower extremities. According to Campanacci classification, patients with a grade I diseae had lower recurrence rate than those with grade II or III disease. There was no significant differences in the recurrence rates based on cryotherapy, the filling of bone cement or bone grafts and surgical margin.

Conclusion

To prevent local recurrence of GCT of bone, curettage of the tumor and elimination of the remaining cells are more important than adjuvant therapy.

Keywords: giant cell tumor of the bone, recurrence rate

REFERENCES

1. Campanacci M, Baldini S, Boriani S, Sudanese A. Giantcell tumor of bone. J Bone Joint Surg Am. 1987; 69:106–14.

2. Eckardt JJ, Grogan TJ. Giantcell tumor of bone. Clin Orthop. 1986; 204:45–58.

3. Siebenrock KA, Unni KK, Rock MG. Giantcell tumor of bone metastasizing to the lungs: a longterm followup. J Bone Joint Surg Br. 1998; 80:43–7.

4. Ghert MA, Rizzo M, Harrelson JM, Scully SP. Giantcell tumor of the appendicular skeleton. Clin Orthop. 2002; 400:201–10.

5. Goldenberg RR, Campbell CJ, Bonfiglio M. Giantcell tumor of bone. An analysis of two hundred and eighteen cases. J Bone Joint Surg Am. 1970; 52:619–64.

6. Larsson SE, Lorentzon R, Boquist L. Giantcell tumor of bone: A demographic, clinical, and histopathological study of all cases recorded in the Swedish Cancer Registry for the years 1958-1968. J Bone Joint Surg Am. 1975; 57:167–73.

7. Malawer MM, Bickels J, Meller I, Buch RG, Henshaw RW, Kol-lender Y. Cryosurgery in the treatment of giant cell tumor: a long term follow up study. Clin Orthop. 1999; 359:176–88.

8. O'Donnell RJ, Springfield DS, Motwani HK, Ready JE, Gebhardt MC, Mankin HJ. Recurrence of giant-cell tumors of the long bones after curettage and packing with cement. J Bone Joint Surg Am. 1994; 76:1827–33.

9. Turcotte RE, Wunder JS, Isler MH, et al. Giantcell tumor of long bone: a Canadian sarcoma group study. Clin Orthop. 2002; 397:248–58.

10. Blackley HR, Wunder JS, Davis AM, White LM, Kandel R, Bell RS. Treatment of giant-cell tumors of long bones with curettage and bone grafting. J Bone Joint Surg Am. 1999; 81:811.

11. Dahlin DC, Cupps RE, Johnson Jr EW. Giantcell tumor: a study of 195 cases. Cancer. 1970; 25:1061–70.

12. Scully SP, Mott MP, Temple HT, O'keefe RJ, O'Donnell RJ, Mankin HJ. Late recurrence of giant-cell tumor of bone: a report of four cases. J Bone Joint Surg Am. 1994; 76:1231–3.

13. Bini SA, Gill K, Johnston JO. Giantcell tumor of bone: Curettage and cement reconstruction. Clin Orthop. 1995; 321:245–50.

14. Fraquet N, Faizon G, Rosset P, Phillipeau JM, Waast D, Gouin F. Long bones giant cells tumors: treatment by curettage and cavity fillng cementation. Orthop Traumatol Surg Res. 2009; 95:402–6.

15. Ayerza MA, Aponte-Tinao LA, Farfalli GL, Restrepo CA, Muscolo DL. Joint preservation after extensive curettage of knee giant cell tumors. Clin Orthop Relat Res. 2009; 467:2845–51.

16. Weber KL. What's new in musculoskeletal oncology. J Bone Joint Surg Am. 2005; 87:1400–10.

Table 1.

Anatomical Distribution of Tumor

Site	No. of patients
Distal femur	20
Proximal tibia	12
Proximal femur	5
Distal radius	5
Distal tibia	3
Proximal humerus	3
Metacarpal bone	2
Sacrum	1
Patella	1
Cuneiform	1
Fibular head	1
Total	54

Table 2.

Recurrence Rate according to Campanacci Classification

Campanacci classification	Total cases (N=54)	Number of patients with recurrence	Percent
Grade I	2	0	0.0%
Grade II	13	3	23.1%
Grade III	39	18	46.2%

Table 3.

Comparison of Recurrence Rate according to Variables

	Recurrence rate	p-value
Anatomical site		0.032
Lower extremity	14/43 (32.6%)
Upper extremity	7/10 (70%)
Filling material after curettage		0.317
Cement	11/29 (37.9%)
Bone graft	6/17 (35.2%)
Cryotherapy		0.038
Done	18/42 (42.6%)
Not done	3/12 (25%)

TOOLS

Similar articles