Giant Cell Tumors of the Upper Extremity: Predictors of Recurrence

• Published in: The Journal of hand surgery (American ed.) Vol. 45; no. 8; pp. 738 - 745
• Main Authors: Lans, Jonathan, Oflazoglu, Kamil, Lee, Hang, Harness, Neil G., Castelein, René M., Chen, Neal C., Lozano Calderón, Santiago A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2020
• Subjects: Giant cell tumor; intralesional curettage; orthopedic oncology; surgical treatment; upper extremity tumors; surgical treatment; upper extremity tumors; orthopedic oncology; Giant cell tumor; intralesional curettage
• ISSN: 0363-5023; 1531-6564
• DOI: 10.1016/j.jhsa.2020.04.020

Giant cell tumors (GCT) of the distal radius are thought to be more aggressive than in other locations. Therefore, the aim of this study was to investigate factors associated with recurrence of GCTs in the upper extremity. We retrospectively identified 82 patients who underwent primary surgical treatment for an upper extremity GCT. Tumors were located in the radius (n = 47), humerus (n = 17), ulna (n = 9), and hand (n = 9). Treatment consisted of either wide resection or amputation or intralesional resection with or without adjuvants. A multivariable logistic regression was performed including tumor grade, type of surgery, and tumor location, from which the percentage of contribution to the model of each variable was calculated. The recurrence rate after intralesional resection was 48%; after wide resection or amputation, it was 12%. Two patients developed a pulmonary metastasis (2.4%). In multivariable analysis, intralesional resection was independently associated with recurrence. Intralesional resection had a 77% contribution to predict recurrence and the distal radius location had a 16% contribution in the predictive model. As expected, intralesional resection was the strongest independent predictor of recurrence after surgical treatment for GCT. The distal radius location contributed to the prediction of giant cell tumor recurrence to a lesser extent. Prognostic IV.