Recurrence of curetted and bone-grafted giant-cell tumours with and without adjuvant phenol therapy

Aims: Giant-cell tumour of bone (GCT) represents 5% of all primary bone tum ours. The aim of this study was to compare the outcome of GCT treated with or without phenol. Methods: Out of 53 patients primarily treated for a giant-cell tumour, 47 w ere followed, with a median follow-up of 11 (range 4-43) years. All patient s were disease-free at the latest follow-up. Of the 40 tumours (85%) locate d in long bones, 14 (35%) were treated by curettage and bone grafting and 1 2 (30%) by additional adjuvant phenol treatment. Fourteen patients (35%) re ceived different therapies, including en-bloc resection, endoprosthesis, ce ment packing or other therapy. Results: There were seven (17.5%) recurrences in long bones after a median of 12 (range 4-60) months, three (3/14, 21%) in the group treated without p henol and three (3/12, 25%) in the group with phenol. Of the seven rumours located in the axial skeleton, two patients died within the first year afte r surgery. The remaining five patients were followed, with a median follow- up of 12 (range 8-23) years. No patients had metastases or a multicentric t umour. Conclusions: Despite the different rates of recurrence reported in literatu re, this study suggests that local recurrence rate of giant-cell tumours lo cated in long bones treated with or without phenol is similar. Adequate rem oval of the tumour seems to be a more important predictive factor for the o utcome of surgery than the use of phenol as an adjuvant therapy. (C) 2001 H arcourt Publishers Ltd.