Study On The Influencing Factors Of Postoperative Recurrence Of Giant Cell Tumor Of Bone

Objective:To explore the influencing factors of postoperative recurrence of giant cell tumor of bone.Methods:The data of 93 patients with GCTB who underwent surgery in the second Hospital of Shanxi Medical University from January 2016 to June 2021 were analyzed retrospectively.The patients’ age,sex,mode of operation,location,pathological fracture,Campanacci grade,pulmonary metastasis,neutrophil count,lymphocyte count,platelet count,serum albumin concentration and prognostic nutrition index,the ratio of neutrophils to lymphocytes,the ratio of platelets to lymphocytes,the ratio of lymphocytes to monocytes,limb function,complications and so on were collected.Statistical analysis was used to explore whether the above factors affect the recurrence after GCTB.Results:Of the 93 patients with GCTB,13 patients with GCTB had recurrence,with a recurrence rate of 12.9%.There were 49 male patients and 44 female patients.The age of the patients ranged from 13 to 70 years old,and the predilection age ranged from 20 to 29 years old.According to the location of the disease,they were divided into four groups: femur group,tibia group,radius group and other groups.Among them,39 cases were located in the femur,4 cases recurred,the recurrence rate was 10.3%,21 cases were located in the tibia,3 cases recurred,the recurrence rate was 14.3%,11 cases were located in the radius,3 cases recurred,the recurrence rate was 27.3%,22 cases were located in other parts,2 cases recurred,and the recurrence rate was 9.1%.All the 93 patients underwent surgical treatment,including segmental resection and reconstruction in 30 cases,recurrence in 1 case,recurrence rate of 3.3%;focus curettage in 63 cases,recurrence in 11 cases,recurrence rate was 15.9%.Among them,the recurrence rates of focus curettage,bone grafting and bone cement filling were 29.6% and 8.3%,respectively.Campanacci I,Campanacci II and Campanacci III are 3.0%,21.6% and 13.0%,respectively.Pathological fracture occurred in 13 cases and relapsed in 1 case.Lung metastasis occurred in 2 cases and recurrence in 1 case.The results of univariate analysis showed that the mode of operation was related to the recurrence of GCTB patients,and the MSTS functional score of 71 patients with GCTB showed that the excellent and good rate of limb function after curettage was significantly higher than that after resection.A total of 4 patients had postoperative complications,including 1 case of infection,2 cases of peri-tumor fracture(1 case of periprosthetic fracture,1 case of fracture after bone grafting)and 1 case of osteoarthritis.Conclusion:1.The mode of operation was the influencing factor of postoperative recurrence in GCTB patients,and there was no significant difference between recurrent and non-recurrent GCTB patients in terms of PNI,NLR,LMR,PLR,age,sex,location,pathological fracture,Campanacci grade and pulmonary metastasis.2.It is the focus of clinical work to achieve the maximum benefit of limb function while reducing recurrence.