The Factors Related To The Recurrence Of Giant Cell Tumors

Background Giant cell tumors of bone rarely metastasize but often recur locally after surgery. There is limited knowledge about the risk of recurrence related to different factors.Patients and methods We analyzed factors affecting the local recurrence rate in 80 patients with giant cell tumors using materials of retrospective research from Xiangya Hospital. The median follow-up time was 5(0.5-13)years.Results Local recurrence was diagnosed in 19 of 80 patients (24%). Kaplan-Meier survival analysis identified young age and Campanacci's photographical grading to be associated with a higher risk of recurrence. There was no correlation between tumor size, sex of the patient, tumor position, tumor location, histological grading,fracture at diagnosis, tumor extension, surgical practice, local adjuvants,the method of filling cavity and outcome. Based on Cox regression analysis, the risk ratios for age and Campanacci's photographical grading did not change substantially,indicating that these associations were probably not due to confounding factors, the another result is that the relative risk of intralesional surgery is higher than that of more extensive operative methods,indicating the potential relationship between surgical practice and the risk of recurrence. Using Kaplan-Meier survival analysis,the risk of second recurrence is higher than the risk of recurrence(P=0.007).Interpretation The young patients of giant cell tumors of bone had an increased risk of local recurrence, so did the patients who had high Campanacci's photographical grading. Although the relative risk of intralesional surgery is higher than that of more extensive operative methods,intralesional surgery should be the first choice in most giant cell tumors, even in the presence of a pathological fracture.