Treatment of Patients Diagnosed with Giant Cell Tumor of Bone: Experience of a Philanthropic Hospital in the State of Piauí, Brazil

Aguiar, Leonardo Telles Alves de; Vasconcelos, Juliani Barros Moura de; Ribeiro, Marcelo Barbosa

doi:10.1055/s-0042-1744498

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Original Article • Rev. bras. ortop. 57 (05) • Sep-Oct 2022 • https://doi.org/10.1055/s-0042-1744498 copy

Treatment of Patients Diagnosed with Giant Cell Tumor of Bone: Experience of a Philanthropic Hospital in the State of Piauí, Brazil^* Study conducted at Associação Piauiense de Combate ao Câncer Alcenor Almeida, Hospital São Marcos, Teresina, PI, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To evaluate the treatment of patients with giant cell tumors of bone treated from 2009 to 2019 in a philanthropic hospital, as well as to try and determine the regional clinical and epidemiological profile, aiming to enrich the Brazilian data set and compare our findings with those of the literature.

Methods

An analytical, observational, and cross-sectional study with retrospective data collection and a quantitative approach, analyzing medical records of patients with giant cell tumors treated at a philanthropic hospital from 2009 to 2019.

Results

We evaluated 49 medical records; 55.1% of the patients were women, 53.1% were aged between 20 and 40 years, 69.4% of the cases were Campanacci grade III, and 30.6% affected the proximal end of the tibia. The rate of pathological fractures secondary to the tumor and pulmonary metastasis was low. More than 69% of the patients underwent intralesional surgery. Recurrence occurred in 16.3% of the cases.

Conclusion

The criteria used for the diagnosis, classification, and treatment at our service followed the standards established by the literature, and they can guide further research and improve local prognosis in the future.

Keywords
giant cell tumors/diagnosis; giant cell tumors/classification; bone neoplasms

Variables	N	%
Gender
Male	22	44.9
Female	27	55.1
Age
< 20 years	1	2.0
20 to 39 years	26	53.1
40 to 60 years	18	36.7
> 60 years	4	8.2
Campanacci classification
Grade I	0	0
Grade II	15	30.6
Grade III	34	69.4
Anatomical site of the tumor
Distal femur	10	20.4
Proximal femur	2	4.1
Fibula	3	6.1
Distal humerus	2	4.1
Proximal tibia	15	30.6
Distal tibia	1	2
Distal radius	6	12.2
Metacarpus	2	4.1
Proximal humerus	3	6.1
Carpus	1	2
Third finger of the right hand	1	2
Fourth finger of the right hand	3	6.1
Pathological fracture secondary to the tumor
Yes	1	2.0
No	48	98.0
Pulmonary metastasis
Yes	2	4.1
No	47	95.9

Variables	N	%
Type of surgery
Intralesional	34	69.4
Grade II	15	30.6
Grade III	19	38.8
Marginal	13	26.5
Grade II	0	0
Grade III	13	26.5
Amputation	2	4.1
Grade II	0	0
Grade III	2	4.1
Type of cavity filling
Bone cement	34	69.4
No filling	15	30.6
Adjuvant therapy
Electrofulguration	34	69.4
None	15	30.6
Use of denosumab
Yes	8	16.3
No	41	83.7
Denosumab indication
Cytoreduction to facilitate surgery	8	100%

#	Age (years)	Gender	Time until recurrence (months)	Campanacci classification	Adjuvant therapy	Type of surgery	Use of denosumab	Tumor location
1	34	Male	14	Grade III	Fulguration	Intralesional	No	Proximal tibia
2	33	Female	44	Grade III	Fulguration	Intralesional	No	Distal femur
3	28	Male	50	Grade II	Fulguration	Intralesional	No	Distal femur
4	51	Female	38	Grade III	Fulguration	Intralesional	No	Proximal tibia
5	31	Male	7	Grade III	Fulguration	Intralesional	No	Proximal humerus
6	49	Male	21	Grade III	None	Marginal	No	Proximal tibia
7	47	Male	6	Grade II	Fulguration	Intralesional	No	Fibula
8	52	Female	14	Grade III	Fulguration	Intralesional	Yes	Proximal tibia

Variables	Recurrence		Total	p-value
Variables	Yes – n (%)	No – n (%)	Total	p-value
Gender
Male	5 (22.7)	17 (77.3)	22	0.440^a
Female	3 (11.1)	24 (88.9)	27	0.440^a
Campanacci classification
Grade II	2 (13.3)	13 (86.7)	15	1^a
Grade III	6 (17.6)	28 (82.4)	34	1^a
Surgery type
Intralesional	7 (20.6)	27 (79.4)	34	0.406^a
Marginal	1 (6.7)	14 (93.3)	15	0.406^a
Site
Proximal tibia	4 (26.7)	11 (73.3)	15	0.227^a
Others	4 (11.8)	30 (88.2)	34	0.227^a

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] Address for correspondence Marcelo Barbosa Ribeiro, Rua Leonardo Castelo Branco, 1.400, Casa 11, Morada do Sol, Teresina, PI, 64056-906, Brazil (e-mail: mbribeiro@hotmail.com).

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Treatment of Patients Diagnosed with Giant Cell Tumor of Bone: Experience of a Philanthropic Hospital in the State of Piauí, Brazil* Study conducted at Associação Piauiense de Combate ao Câncer Alcenor Almeida, Hospital São Marcos, Teresina, PI, Brazil.

Abstract

Objective

Methods

Results

Conclusion

Treatment of Patients Diagnosed with Giant Cell Tumor of Bone: Experience of a Philanthropic Hospital in the State of Piauí, Brazil^* Study conducted at Associação Piauiense de Combate ao Câncer Alcenor Almeida, Hospital São Marcos, Teresina, PI, Brazil.