Correlation Analysis Between Clinicopathologic Features,Surgical Methods And Local Recurrence In Giant Cell Tumor Of Bone

Objective:To compare the association between clinicopathologic features, surgical methods and local recurrence, explore factors on the risk of recurrence, selection and effects of operation ways in Giant cell tumor of bone (GCTB) patients, and expect to provide a reference basis for the decrease of recurrence and treatment of GCTB.Methods:We retrospectively reviewed179patients treated for benign GCTB between1998and2010. Recurrence rates based on different surgical methods were determined. Kaplan-Meier survival analysis and the Log-Rank test were performed in the univariate analysis for factors of clinicopathologic features and surgical methods. Multivariate Cox regression was used to analyze the risk factors of local recurrence and determine the best prognostic factors for recurrence. The mean follow-up was60.2±18.7months (range,36～112months).Results:The local recurrence rate of extensive curettage (19.0%) was closed to that of curettage (7.7%) and lower than that of wide resection (41.9%).Kaplan-Meier analysis showed that there were no statistically significances between sex, age, location, Campanacci grade, pathologic fracture and local recurrences. Soft tissue extension increased the local recurrence rate. The recurrence-free survival rate of pathologic fracture patients with soft tissue extension was significantly lower than that of pathologic fracture patients without soft tissue extension. Use of high-speed burr and bone cement decreased the rate of local recurrence. The recurrence-free survival rate had no statistically significant difference between extensive curettage and wide resection. The recurrence-free survival rate of extensive curettage was significantly higher than that of curettage. Multivariate Cox regression analysis indicated that the independent variable that contributed to recurrence-free survival was soft tissue extension and surgical methods.Conclusions:There were no statistically significances between sex, age, location, Campanacci grade, pathologic fracture and local recurrences. Soft tissue extension increased the risk of local recurrence. Use of high-speed burr and bone cement decreased the risk of local recurrence obviously. The key to reducing local recurrence rate is the thoroughness of tumor removal. The results of the present study suggest that treatment of giant cell tumor patients by extensive curettage provides favorable local control and satisfactory functional outcomes.