Giant cell tumor of bone: effect of different surgical techniques and adjuvants on local recurrence rate

We investigated how different surgical techniques and the use of adjuvants may influence and even prevent local recurrences according to the site and radiological grading of the tumor. Thirty-nine patients with Giant cell tumor (GCT) of bone were treated between 1975 and 2002. According to the site, age and radiological grading (Campanacci) of the lesion, surgical treatment consisted of marginal, wide or radical resection of the tumor, curettage with or without adjuvants, filling the cavity with either autologous or homologous grafts or with methylmetacrylate cement. Eight patients (21%) presented a local recurrence at an interval ranging from 9 months to 13 years after primary treatment; 75% of them had been treated with curettage alone. None of the recurrences occurred in cases treated with curettage and adjuvants. We emphasize the use of adjuvant therapy as part of the treatment of GCT, but believe that low the risk of recurrence is also related to how thoroughly the tumor is removed, because adjuvants alone cannot prevent recurrence if the tumor has not been adequately removed.