MALIGNANT GIANT-CELL TUMORS OF BONE - CLINICOPATHOLOGICAL TYPES AND PROGNOSIS - A REVIEW OF 29 CASES

Twenty-nine patients with malignant giant-cell tumours of bone (GCT) w ere followed-up for between 6 months and 18 years. Seventeen of the tu mours were primary and 12 were due to malignant degeneration of initia lly benign lesions. The clinical features did not differ from those of benign GCT, except for a higher incidence in the distal tibia and sac rum. Anaplastic GCTs were included in the study because their clinical and radiographic features and prognosis were no different from those of the GCT grade III of Jaffe. Eighteen of the tumours were grade III, and II were anaplastic. This retrospective study was intended to asse ss the effects of chemotherapy and surgery for malignant GCT Three tre atment groups were selected, in which treatment was either by surgery alone, surgery plus chemotherapy, or radiotherapy alone. The prognosis was poor and the 5 year tumour-free survival rate in the series was 5 0%. The prognosis was the same for primary as for secondarily malignan t tumours. There was no statistical difference in survival between mal ignant grade III and anaplastic malignant tumours. The one-year surviv al rate for patients treated by chemotherapy and surgery was statistic ally higher (chi(2) test) than for persons treated by surgery alone. H owever, the five-year survival rate and the actuarial survival curves were not statistically different in the two groups (log rank test). Ch emotherapy appears to be of some value in the treatment of these malig nant tumours but a larger series is required to confirm the efficacy o f this approach.