GIANT-CELL TUMOR OF BONE - ONCOLOGICAL AND FUNCTIONAL RESULTS OF LONG-TERM FOLLOW-UP

Background: Giant cell tumor (GCT) of bone is a rare and unpredictable lesion. Its standard treatment has ranged from surgical curettage to wide resection and varying oncological and functional results have bee n reported. Methods: A retrospective review of 47 patients (17 males a nd 30 females) with GCT of bone was performed to evaluate the oncologi cal and functional results. The patients were followed up for at least 5 years. The average age of the patients was 32 years (range 15-66 ye ars). The tumor sites were distal femur in 15 cases, proximal tibia in 10, distal radius in five, spinal column in four, proximal femur in t hree, proximal humerus in three, proximal fibula in two, pelvis in two and others in three. Enneking's surgical stages were Stage 1 in three , Stage 2 in 34 and Stage 3 in 10 cases. In these 47 patients, 80 surg ical procedures were performed. Results: The rate of local recurrence was 75% in the 28 patients undergoing intralesional excision, 50% in t hose receiving excision and curettage and 0% in those receiving wide r esection. Although there was no statistical significance, surgical sta ges tended to be correlated with the local recurrence rate (Stage 1, 0 %; Stage 2, 53%; Stage 3, 70%). Functional evaluation was performed ac cording to the most recent system of the Musculoskeletal Tumor Society . Functional results of the patients with extremity tumors were 28.2 ( average) in those undergoing intralesional excision, 30 (average) in t hose receiving excision and curettage and 27.1 (average) in those rece iving wide resection. Functional results were significantly correlated with the initial surgical stages (Stage 1, 30; Stage 2, 27.5; Stage 3 , 24.4; Kruskal-Wallis test, P = 0.016), Conclusions: To preserve good function of the extremities and avoid local recurrence, we consider t hat intralesional excision with adjunctive therapy such as phenol caut erization should be employed for the treatment of benign GCT of bone.