The clinical, functional and oncological outcomes of patients with giant cell tumour of bone. A long-term review.

Abstract

IntroductionGiant cell tumour of bone is a benign but locally aggressive condition associated with a risk of recurrence and functional impairment. This study aimed to evaluate the clinical presentation, functional outcomes, and oncological outcomes of patients with giant cell tumour of bone treated at a tertiary orthopaedic oncology centre, with particular emphasis on local recurrence, pulmonary metastasis, surgical management, and survival.MethodsA single-centre retrospective cohort study was conducted involving 151 patients with histologically confirmed giant cell tumour of bone treated between 2006 and 2023. Demographic characteristics, tumour location, treatment modality, recurrence, metastasis, and survival outcomes were analysed. Functional outcomes were assessed using the Musculoskeletal Tumour Society (MSTS) score and the Toronto Extremity Salvage Score (TESS) in a subset of 114 patients (75.5%)<b>. Time-to-event outcomes, including local recurrence-free survival, were analysed using Kaplan-Meier methods</b>. The mean duration of follow-up was 81.7 ± 63.8 months.ResultsLocal recurrence occurred in 17 patients (11.3%), with a 5-year local recurrence-free survival rate of 88.1%. <b>Pulmonary metastasis was observed in 5 patients (3.3%). Among the 114 patients with available clinical and functional data, intralesional curettage was associated with significantly higher functional scores than wide resection (MSTS: 87.4 ± 8.1 vs 70.9 ± 14.3, p < 0.001; TESS: 89.9 ± 6.8 vs 80.1 ± 11.2, p < 0.001)</b> for tumours in the lower limb. No significant functional differences were observed between surgical approaches in the upper limb. The five-year overall survival rate was 94.7%. <b>Five-year disease-free survival and event-free survival rates were 87.7% and 82.7%, respectively. Median survival outcomes were not reached.</b>ConclusionGiant cell tumour of bone demonstrates excellent long-term survival, with local recurrence representing the primary oncological challenge. Intralesional curettage provides superior functional outcomes for selected lower-limb tumours, while wide resection remains essential for aggressive or recurrent disease.