Journal of Cancer Research and Clinical Oncology

, Volume 134, Issue 9, pp 969–978 | Cite as

Giant cell tumor of bone: treatment and outcome of 214 cases

  • Maurice Balke
  • Laura Schremper
  • Carsten Gebert
  • Helmut Ahrens
  • Arne Streitbuerger
  • Gabriele Koehler
  • Jendrik Hardes
  • Georg Gosheger
Original Paper

Abstract

Background

Two hundred and fourteen patients with benign giant cell tumor of bone (GCTB), treated from 1980 to 2007 at the Department of Orthopedics of the University of Muenster (Germany), were analyzed in a retrospective study.

Patients and methods

The mean age was 33.3 years with a female-to-male ratio of 1.2 : 1. The mean follow up was 59.8 months. The recurrence rate of patients who received first treatment at our institution was 16.6%. The most common primary treatment was curettage (188 patients) usually followed by adjuvant local therapy. The effects of bone cement (PMMA), burring and hydrogen peroxide (H2O2) were statistically analyzed and the influence of a subchondral bone graft on the recurrence rate was evaluated.

Results

PMMA alone (n = 52) reduces the likelihood of recurrence by the factor 8.2, additional high-speed burring (n = 39) by the factor 3.9 (compared to PMMA only). H2O2 (n = 42) seems to have an additional effect comparable to that of phenol although it did not reach statistical significance.

Conclusion

The combination of all adjuncts (PMMA, burring, H2O2 − n = 42) reduces the likelihood of recurrence by the factor 28.2 compared to curettage only and therefore should be recommended as a standard treatment. If the tumor reaches close to the articulating surface a subchondral bone graft (n = 42) can be performed without risking a higher recurrence rate. We add seven cases of pulmonary metastases and two cases of multicentricity to the literature. Bisphosphonates and interferon alpha may have a beneficial effect.

Keywords

Giant cell tumor of bone Bone neoplasm Local recurrence Hydrogen peroxide Bone cement Curettage Pulmonary metastases 

Notes

Conflict of interest statement

Each author certifies that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Maurice Balke
    • 1
  • Laura Schremper
    • 1
  • Carsten Gebert
    • 1
  • Helmut Ahrens
    • 1
  • Arne Streitbuerger
    • 1
  • Gabriele Koehler
    • 2
  • Jendrik Hardes
    • 1
  • Georg Gosheger
    • 1
  1. 1.Department of Orthopedic SurgeryUniversity of MuensterMuensterGermany
  2. 2.Gerhard-Domagk-Institute of PathologyUniversity of MuensterMuensterGermany

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