BACKGROUND: Giant cell tumor of bone (GCTB) is a locally aggressive bone tumor, with recurrence being its major clinical complication. Surgery remains the primary treatment modality, and numerous factors may influence the risk of recurrence. This study aimed to retrospectively analyze the incidence of local recurrence of GCTB and the related risk factors in a single-center cohort.
PATIENTS AND METHODS: A total of 340 patients with benign GCTB treated at our center between 2002 and March 2023 were retrospectively reviewed, including 172 males and 168 females. The mean age was 34.04 ± 12.83 years (range, 13-78 years). In 48.2% of patients, tumors were located in the distal femur or proximal tibia. Surgical procedures consisted of extended curettage and wide resection. All the patients were followed up with a minimum duration of 24 months.
RESULTS: The overall recurrence rate was 20.00%, with a mean recurrence interval of 21.90 ± 14.57 months (range, 3-67 months). Multivariable Cox regression analysis demonstrated that surgical type and sex were independent risk factors for recurrence-free survival. The recurrence rate following extended curettage was 22.55%, significantly higher than that following wide resection (9.23%) (HR, 4.75; 95% CI, 2.02 to 11.19; p < 0.001). Male patients had a recurrence rate of 15.12%, significantly lower than that of female patients (25.00%) (HR, 0.53; 95% CI, 0.32 to 0.87; p = 0.01). In the extended curettage group, female sex and Campanacci grade Ⅲ were identified as recurrence risk factors.
CONCLUSIONS: Tumor recurrence may develop in approximately one-fifth of the patients who underwent surgical treatment of GCTB. Extended curettage was independent risk factors for the local recurrence. Specifically, for the extended curettage group, patients with Campanacci grade III are recommended with closer follow-up.
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