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Comparing clinical outcomes between extended curettage and wide resection in Enneking stage 3 giant cell tumor of bone

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Abstract

Purpose

Our objectives were (1) to compare the recurrence, metastases, and complication rates of patients with Enneking stage 3 GCTB who underwent extended curettage vs wide resection and (2) examine the factors which might influence surgical options for each patient.

Methods

We retrospectively reviewed the records of patients with Enneking stage 3 GCTB from January 2006-December 2015. Extended curettage was performed in patients in whom there was a moderate expansile lesion, minimal/no articular cartilage damage, and less than 50% of cortical deformation compared to its circumference from a CT scan/MRI. The percentages of cortical deformation were collected. Surgical complications, recurrence, and metastatic rates were analyzed.

Results

There were 28 extended curettage and 41 wide resections. The mean percentages of cortical deformation compared to circumference were 52.6% (range, 23.9–81.9%) and 91.6% (range, 52.1–100%)(P < 0.01) for the curettage and wide resection groups, respectively. There were three recurrences, 2/28 (7.1%) from the curettage group and 1/41 (2.4%) from the resection group (P = 0.56). There were no cases of pulmonary metastasis. There were two complications in the curettage group and five complications in the resection group.

Conclusion

Both extended curettage and wide resection are useful methods to treat Enneking stage 3 GCTB. Extended curettage with proper technique is a viable option showing no difference in local recurrence rate and potentially fewer complications. Preference to do extended curettage in patients in whom when the articular cartilage has minimal or no destruction, a moderate expansile lesion and the cortical deformation is less than 50% of the circumference.

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Availability of data and materials

The datasets generated during this current study are available from the corresponding author upon reasonable request.

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Acknowledgements

All of the subjects were patients in Lerdsin Hospital, Bangkok, Thailand. Thanking Lerdsin hospital for permitted me to study this research. The authors wish to thank Dave Patterson for his assistance with English proof reading.

Funding

No funds, grants, or other support was received.

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Authors and Affiliations

  1. Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand

    Pakjai Tuntarattanapong

  2. Orthopaedic Oncology Unit, Institute of Orthopaedics, Lerdsin Hospital, Bangkok, Thailand

    Pongsiri Piakong, Bhasanan Sukanthanak & Piya Kiatisevi

  3. Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok, Thailand

    Thanapon Chobpenthai

Authors
  1. Pakjai Tuntarattanapong
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  2. Pongsiri Piakong
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  4. Bhasanan Sukanthanak
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  5. Piya Kiatisevi
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Contributions

PJ, PP, and PK were responsible for the design, literature search, and data interpretation. PJ and PK were responsible for the data collection. PJ did the statistical analysis and prepared the first draft. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Piya Kiatisevi.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study was performed in line with the principles of the Declaration of HELSINKI. This study was approved by the Lerdsin Ethics Committee of Lerdsin hospital (LH621073).

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Written informed consent was obtained from all individual participants whose information was included in this study.

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Tuntarattanapong, P., Piakong, P., Chobpenthai, T. et al. Comparing clinical outcomes between extended curettage and wide resection in Enneking stage 3 giant cell tumor of bone. Eur J Orthop Surg Traumatol 33, 135–142 (2023). https://doi.org/10.1007/s00590-021-03168-w

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  • DOI: https://doi.org/10.1007/s00590-021-03168-w

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