Oncological and functional results following operation for giant cell tumour of bone

Objective:Giant cell tumours(GCT)represent one of the most common benign tumours of bone.However,despite its benign nature they are aggressive lesions that have a tendency to recur.This study aims to report experience with the treatment of GCTs,and reviews the relationship between surgical management and clinical outcome.Methods:A retrospective review was performed with 70 patients(32 males and 38 females)who presented to our institution between 1991 and 2001 with GCT of bone.An evaluation of the oncological and functional results was conducted and patients were divided into three groups according to the treatment method;GroupⅠ:(46 patients)intralesional curettage and adjuvant therapy and packing with filling materials.GroupⅡ:(18 patients)en-bloc resection and arthrodesis or reconstruction.GroupⅢ:(6 patients)amputation.Results:The mean follow-up period was 10 years(range,5-15 years).The overall rate of local recurrence was 14%,22% in Group I,and only 4% in GroupⅡ and GroupⅢ.According to the Musculoskeletal Tumour Society(MSTS)score for functional outcome,the mean overall score for Group I was 27.9(out of 30),15.9 for GroupⅡ.Of note,the 9 patients within GroupⅡ who received endoprosthetic reconstruction,the mean overall MSTS functional score was 25.5.Conclusion:Intralesional curettage with adjuvant therapies and filling agents is often associated with a relatively high recurrence rate,however joint function is well preserved.Patients with more extensive,biologically aggressive,and/or recurrent tumours are best treated with en-bloc resection.