GIANT CELL TUMOR OF BONE: A MULTICENTER EPIDEMIOLOGICAL STUDY IN BRAZIL

Overview

Journal Acta Ortop Bras

Specialty Orthopedics

Date 2024 Mar 27

PMID 38532872

Authors

Ricardo Gehrke Becker

Carlos Roberto Galia

Julie Francine Cerutti Santos Pestilho

Bruno Pereira Antunes

Andre Mathias Baptista

Alex Guedes

Affiliations

Soon will be listed here.

Abstract

Introduction: Giant cell tumor of bone (GCTB) mainly affects young adults' long bone epiphyses, threatening bone strength and joint function. Surgery is the primary treatment, although post-surgery recurrence is significant. This study analyzes patient profiles, treatments, and outcomes for GCTB in Brazil.

Methods: We retrospectively assessed local recurrence, metastasis, and treatment approaches in 643 GCTB patients across 16 Brazilian centers (1989-2021), considering regional differences.

Results: 5.1% (n=33) developed pulmonary metastases, 14.3% (n=92) had pathological fractures, and the local recurrence rate was 18.2% (n=114). Higher rates of pulmonary metastases (12.1%) and advanced tumors (Campanacci III, 88.9%) were noted in lower-income North and Northeast regions. The North also had more pathological fractures (33.3%), extensive resections (61.1%), and amputations (27.8%). These regions faced longer surgical delays (36-39 days) than the South and Southeast (27-33 days).

Conclusions: Our findings corroborate international data, underscoring regional disparities in Brazil that may lead to worse outcomes in disadvantaged areas. This highlights the need for improved orthopedic oncology care in Brazil's economically and structurally challenged regions.

Citing Articles

Immunohistochemical Characterization of Feline Giant Cell Tumor of Bone (GCTb): What We Know and What We Can Learn from the Human Counterpart.

Porcellato I, Giglia G, Leonardi L Animals (Basel). 2025; 15(5).

PMID: 40075982 PMC: 11898444. DOI: 10.3390/ani15050699.

Management and surveillance of metastatic giant cell tumour of bone.

Fellows D, Kotowska J, Stevenson T, Brown J, Orosz Z, Siddiqi A Pathol Oncol Res. 2025; 31:1611916.

PMID: 40046036 PMC: 11879744. DOI: 10.3389/pore.2025.1611916.

GIANT CELL TUMOR OF THE DISTAL RADIUS: FACTORS ASSOCIATED WITH LOCAL RECURRENCE.

Rabuske W, Ghert M, Antunes B, Galia C, Santos Pestilho J, da Silveira G Acta Ortop Bras. 2025; 33(1):e289573.

PMID: 39927322 PMC: 11801205. DOI: 10.1590/1413-785220253301e289573.

TREATMENT OF PATIENTS WITH GIANT CELL BONE TUMOR IN NORTHERN BRAZIL, IN 2020 AND 2021.

do Couto F, Yonamine E, Magno F, Favacho-Silva A, de Brito C, Brito T Acta Ortop Bras. 2025; 33(1):e285342.

PMID: 39927320 PMC: 11801210. DOI: 10.1590/1413-785220253301e285342.

Repurposing of PSMA-targeted diagnostic and therapeutic agents for the detection and treatment of giant cell tumors of bone.

McAllister B, Mesbahi N, Dodson E, Abdulsalam S, Berkman C, Caromile L Front Oncol. 2024; 14:1504514.

PMID: 39619440 PMC: 11604636. DOI: 10.3389/fonc.2024.1504514.

References

Liede A, Bach B, Stryker S, Hernandez R, Sobocki P, Bennett B . Regional variation and challenges in estimating the incidence of giant cell tumor of bone. J Bone Joint Surg Am. 2014; 96(23):1999-2007. DOI: 10.2106/JBJS.N.00367. View

Turcotte R, Wunder J, Isler M, Bell R, Schachar N, Masri B . Giant cell tumor of long bone: a Canadian Sarcoma Group study. Clin Orthop Relat Res. 2002; (397):248-58. DOI: 10.1097/00003086-200204000-00029. View

Souza Junior P, Szwarcwald C, Damacena G, Stopa S, Vieira M, Almeida W . Health insurance coverage in Brazil: analyzing data from the National Health Survey, 2013 and 2019. Cien Saude Colet. 2021; 26(suppl 1):2529-2541. DOI: 10.1590/1413-81232021266.1.43532020. View

Prosser G, Baloch K, Tillman R, Carter S, Grimer R . Does curettage without adjuvant therapy provide low recurrence rates in giant-cell tumors of bone?. Clin Orthop Relat Res. 2005; (435):211-8. DOI: 10.1097/01.blo.0000160024.06739.ff. View

Deheshi B, Jaffer S, Griffin A, Ferguson P, Bell R, Wunder J . Joint salvage for pathologic fracture of giant cell tumor of the lower extremity. Clin Orthop Relat Res. 2007; 459:96-104. DOI: 10.1097/BLO.0b013e31805d85e4. View

Junming M, Cheng Y, Dong C, Jianru X, Xinghai Y, Quan H . Giant cell tumor of the cervical spine: a series of 22 cases and outcomes. Spine (Phila Pa 1976). 2008; 33(3):280-8. DOI: 10.1097/BRS.0b013e318162454f. View

ODonnell R, Springfield D, Motwani H, Ready J, Gebhardt M, Mankin H . Recurrence of giant-cell tumors of the long bones after curettage and packing with cement. J Bone Joint Surg Am. 1994; 76(12):1827-33. DOI: 10.2106/00004623-199412000-00009. View

Chawla S, Blay J, Rutkowski P, Cesne A, Reichardt P, Gelderblom H . Denosumab in patients with giant-cell tumour of bone: a multicentre, open-label, phase 2 study. Lancet Oncol. 2019; 20(12):1719-1729. DOI: 10.1016/S1470-2045(19)30663-1. View

Klenke F, Wenger D, Inwards C, Rose P, Sim F . Giant cell tumor of bone: risk factors for recurrence. Clin Orthop Relat Res. 2010; 469(2):591-9. PMC: 3018195. DOI: 10.1007/s11999-010-1501-7. View

10.

Luengo-Alonso G, Mellado-Romero M, Shemesh S, Ramos-Pascua L, Pretell-Mazzini J . Denosumab treatment for giant-cell tumor of bone: a systematic review of the literature. Arch Orthop Trauma Surg. 2019; 139(10):1339-1349. DOI: 10.1007/s00402-019-03167-x. View

11.

Mozaffarian K, Modjallal M, Vosoughi A . Treatment of giant cell tumor of distal radius with limited soft tissue invasion: Curettage and cementing versus wide excision. J Orthop Sci. 2017; 23(1):174-179. DOI: 10.1016/j.jos.2017.10.001. View

12.

Balke M, Henrichs M, Gosheger G, Ahrens H, Streitbuerger A, Koehler M . Giant cell tumors of the axial skeleton. Sarcoma. 2012; 2012:410973. PMC: 3289906. DOI: 10.1155/2012/410973. View

13.

Siebenrock K, Unni K, Rock M . Giant-cell tumour of bone metastasising to the lungs. A long-term follow-up. J Bone Joint Surg Br. 1998; 80(1):43-7. DOI: 10.1302/0301-620x.80b1.7875. View

14.

Verschoor A, Bovee J, Mastboom M, Dijkstra P, van de Sande M, Gelderblom H . Incidence and demographics of giant cell tumor of bone in The Netherlands: First nationwide Pathology Registry Study. Acta Orthop. 2018; 89(5):570-574. PMC: 6202770. DOI: 10.1080/17453674.2018.1490987. View

15.

Wang J, Liu X, Yang Y, Yang R, Tang X, Yan T . Pulmonary metastasis of giant cell tumour: a retrospective study of three hundred and ten cases. Int Orthop. 2021; 45(3):769-778. DOI: 10.1007/s00264-020-04907-0. View

16.

Errani C, Ruggieri P, Asenzio M, Toscano A, Colangeli S, Rimondi E . Giant cell tumor of the extremity: A review of 349 cases from a single institution. Cancer Treat Rev. 2009; 36(1):1-7. DOI: 10.1016/j.ctrv.2009.09.002. View

17.

Liu Y, Li K, Sun B . Which treatment is the best for giant cell tumors of the distal radius? A meta-analysis. Clin Orthop Relat Res. 2012; 470(10):2886-94. PMC: 3442009. DOI: 10.1007/s11999-012-2464-7. View