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The Journal of Bone and Joint Surgery, Vol 76, Issue 12 1827-1833, Copyright © 1994 by Journal of Bone and Joint Surgery, Inc
Recurrence of giant-cell tumors of the long bones after curettage and packing with cement
RJ O'Donnell, DS Springfield, HK Motwani, JE Ready, MC Gebhardt and HJ Mankin
Orthopaedic Oncology Unit, Massachusetts General Hospital, Boston 02114.
The nine-year experience with sixty patients who had had a giant-cell tumor
of a long bone was reviewed to determine the rate of recurrence after
treatment with curettage and packing with polymethylmethacrylate cement.
The demographic characteristics, including the age and sex of the patient
and the site of the tumor, were similar to those that have been reported
for other large series. An average of four years (range, two to ten years)
after the operation, the over-all rate of initial local recurrence was 25
per cent (fifteen of sixty patients). Patients who had had a tumor of the
distal aspect of the radius had a higher rate of recurrence (five of ten)
than those who had had a tumor of the proximal aspect of the tibia (seven
[28 per cent] of twenty-five) or of the distal part of the femur (three [13
per cent] of twenty-three). Higher rates of recurrence were also noted for
patients who had had a pathological fracture (three of six), those who had
had a Stage-III tumor according to the classification of Campanacci et al.
(six of sixteen), and those who had not had adjuvant treatment with either
a high-speed burr or phenol (eight of nineteen). Patients who had had an
initial recurrence after packing with cement had a low rate of secondary
recurrence when the initial recurrence had been treated with a wide
resection or a second intralesional procedure (zero of ten and one of five
patients, respectively), after an average of three years (range, ten months
to eight years). No patient had a multicentric tumor or
metastasis.(ABSTRACT TRUNCATED AT 250 WORDS)
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