Abstract
Objective To identify the recurrence rate of giant-cell tumor (GCT) in patients treated by curetage and adjuvant therapy with polymethil metacrylate with a minimum follow-up of 3 years.
Methods Observational and retrospective cohort with patients with diagnoses of Enneking stages 1 and 2 GCT treated through intralesional curetage and cementation between 1981 and 2011. Age, gender, anatomic location and relapse period were recorded. The data was analyzed with measures of central tendency and dispersion (standard deviation) for the quantitative variables, percentages for the qualitative variables.
Results Between 1981 and 2011 375 cases of GCT were identified, 141 (36.7%) of which were treated by this method. The follow-up ranged from 48 to 240 months, the age was of 27 ± 9 years, 45% of the patients were female, and 55%, male, with a female:male ratio of about 1.2:1. The tibia was the most frequent affected bone (38%), followed by the femur (32%), the humerus (16%), and the radius (10%). The resection thecnique was intralesional curetage in about 88.6% of the cases, and marginal resection in the remaining cases. Pathologic fracture was present in approximately 15.7%, and recurrence occurred in approximately 12.7%.
Discussion We demonstrated that this treatment method decreases the risk of recurrence due to the local adjuvant effects of acrylic cementation. Recurrence events occur in the first two years after resection. However, some authors defend that the surgical margin is the only factor that influences the risk of local recurrence. The extraosseus extension of GCT is not a contraindication to perform intralesional curetage or to prescribe the adjuvant treatment with polymethyl metacrylate.
Conclusions We reported a recurrence rate similar to that of the literature, and this is a feasible resource for limb reconstruction.
Keywords
giant-cell tumor - treatment - resection - polymethyl metacrylate
