Analysis Of The Factors Affecting The Recurrenc Of Gaint Cell Tumor Of Bone After Surgery

Objectives To analyze the clinical factors afecting the recurrence of giant cell tumors (GCT) of bone after surgery. The complete data of 157cases with GCT were reviewed.83 cases were males and 74 cases were females with an average of 31.6 years (range,15-89years),120 cases (76.4%) were from 20 to 40years old. By the Jaffe's classification,72 cases were in Grade I,82 in Grade II, and 3 in GradeⅢ. By the Campanicci's radiological grading system,54 cases were in Grade I,84 in GradeⅡ, and 19 in GradeⅢ. By the Enneking classification,80 patients were in Grade I,49 in GradeⅡ, and 28 in GradeⅢ.15 cases had pathological fractures, and Tumor had burst out of bone-envelope appearance in 28 patients. Tumor cells had transferred to lung befor surgery in 3cases. The anatomic site for the lesions were the distal femur (34cases,21.7%),proximaltibia(36cases,22.9%),distalradius(32cases,20.4%),fibu la(9cases,5.7%),humerus(11cases,7.0%),proximalfemur(5cases,3.2%),pelvis(8ca ses,5.1%),others(22cases,14%).Theintralesionalexcision(curettage)with the bone grafting was performed on 33 patients; the curettage with some adjuvant treatments (95%alcohol,Hypertonic Saline Solution)was used in 40 patients,lesion excision on 43 patients, and resection of the whole tumor was performed on 39 patients, amputation of limbs on 2 patients.7 patients had chemotherapy after surgery.All clinical data had been gathered of all 157 patients. Thirteen clinical factors were analyzed by t-test or x2 analysis.Multipal factors were analyzed by Logistic regression analysis.Results The follow up of the 157 patients for 18—176 months (average, 38.3 months)revealed that nineteen of 146 patients recurred. and recurence rate Was 13.0%. Duration of the recurrence ranged from 3 months to 144 months (average,20.3 months); 89.8% cases recurred within three years.79 recurrent lesions (50.3%) were around the knee. Respectively, The seven factors of age, Jaffe's classification, Campanicci's grade, Enneking classification,surgery method, pathological fractures and burst out of bone-envelope appearance were related with the recurrence. Moreover, Logistic regression revealed that the surgery method and Campanicci's grade afected the recurence merely.Conclusion Surgery method and Campanicci's grade afected the recurence.