Clinical Diagnosis and Treatment of Giant Cell Tumor of Bone Treated by Expanded Curettage and Bone Cement Filling

Abstract：Objective To explore the clinical effect of expand curettage and bone cement filling in (giant cell tumor of bone, GCT) treatment, in order to further guide clinical diagnosis and treatment.Methods We retrospective analyzed64 cases of GCT patients treated by expanded curettage and bone cement filling in our hospital, including 28 males and36 females with a mean age of 31.6 years (range, 16～59 y).Tumors were located in distal femur in 26 cases, proximal tibia in 17 cases, proximal femur in 8 cases, proximal humerus in 10 cases, talus in 2 cases and calcaneus in 1 case.Tumor image was graded according to the Campanacci classification criteria.There were 20 patients with grade I, 29 patients with gradeⅡ, and 15 patients with gradeⅢ.Eight clinical factors were analyzed by single factor analysis, such as gender, age, location of tumor, Campanacci classification, MSTS score, whether having apathological fracture, Whether having a soft tissue mass, tumor size and tumor recurrence.Logistic regression analysis was used in multi-factor analysis, and the correlation between Campanacci grades and tumor recurrence was analyzed byχ2 analysis.Results All 64 patients were followed up for 12 to 74 months, with an average of 42.8 months.Eight of 64 cases recurred with recurrence rate was12.5％.There was no distant metastasis and malignant transformation after operation.The postoperative evaluation of limb function was (27.06±1.45).The results of multivariate logistic regression model indicated that Campanacci grades was a key factor affecting tumor recurrence (regression coefficien t=2.368, P=0.04).The P values of recurrence rates were 0.007 and 0.002 for Campanacci grade I and gradeⅡ, as well as grade I and gradeⅢ, respectively after the analysis ofχ2 test, suggesting a statistical significance in their difference (P＜0.05).The P value of CampanacciⅡ andⅢ was 0.23, which did not show any statistical significance (P＞0.05).There were no complications such as articular surface collapse and fracture in the long-term follow-up group after operation.Instead, the joint mobility was good and walking function was satisfactory.Conclusion Expanded curettage and bone cement filling treatment is a reliable treatment for GCT, The overall recurrence rate is relatively low and the recovery of limb function is satisfactory.The Campanacci grades is the key factor that affects the recurrence.