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Published in: Journal of Orthopaedic Science 5/2011

01-09-2011 | Original Article

Giant cell tumour of bone: an analysis of 139 Indian patients

Authors: Kabul Chandra Saikia, Sanjeev Kumar Bhuyan, Munin Borgohain, Swapna Pran Saikia, Anjan Bora, Firoz Ahmed

Published in: Journal of Orthopaedic Science | Issue 5/2011

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Abstract

Background

Giant cell tumour of bone (GCT) is a benign but locally aggressive lesion. We analysed a series of GCTs of bone to determine whether there was any variation in the incidence and distribution in an Indian population compared to other populations reported in the literature, as well as treatment options applicable in developing countries, and we report the results here.

Methods

A total of 139 patients with histologically proven GCT of bone were treated in our referral centre. Of these, 124 cases had a follow-up of more than 2 years (mean 8.3 years). Demographically, 72 were male, 67 were female, and they had a mean age of 29 years (range 15–59 years). The majority of the cases were of Campanacci grade III (n = 72, 51.1%). A total of 157 oncological procedures were performed.

Results

Incidence of GCT of bone was found to be 20.3% (n = 139/685) among all primary bone tumours. The distal radial involvement amounted to 22.7% (n = 28). There were 14 recurrences (11.1%) and 3 re-recurrences. Functional outcome was evaluated using the MSTS-93 scoring system. Average rating was 89.6% (avg. score 26.9) for upper extremities and 84% (avg. score 25.2) for lower extremities.

Conclusions

The incidence of GCT of bone was found to be high in our population, with surprisingly high involvement of the distal radius. Nonvascularised autogenous fibular graft was found to be an effective option for reconstruction. The Indian population, like their South East Asian neighbours, has a higher incidence of GCT compared to Western populations described in the literature.
Literature
1.
go back to reference Eckardt JJ, Grogan TJ. Giant cell tumour of bone. Clin Orthop. 1986;204:45–58.PubMed Eckardt JJ, Grogan TJ. Giant cell tumour of bone. Clin Orthop. 1986;204:45–58.PubMed
2.
go back to reference Sung HW, Kup DP, Shu WP, Chai YP, Liu CC, Li SM. Giant cell tumour of bone: analysis of two hundred and eight cases in Chinese patient. J Bone Joint Surg Am. 1982;64:755–61.PubMed Sung HW, Kup DP, Shu WP, Chai YP, Liu CC, Li SM. Giant cell tumour of bone: analysis of two hundred and eight cases in Chinese patient. J Bone Joint Surg Am. 1982;64:755–61.PubMed
4.
go back to reference Ng ES, Saw A, Sengupta S, Nazarina AR, Path M. Giant cell tumour of bone with late presentation: review of treatment and outcome. J Orthop Surg (Hong Kong). 2002;10(2):120–8. Ng ES, Saw A, Sengupta S, Nazarina AR, Path M. Giant cell tumour of bone with late presentation: review of treatment and outcome. J Orthop Surg (Hong Kong). 2002;10(2):120–8.
5.
go back to reference Peh SC, Cheah PL, Sengupta S. The pathology of tumour and “tumour-like” lesions of bone in the University Hospital Kuala Lumpur. Malays J Pathol. 1988;10:45–50.PubMed Peh SC, Cheah PL, Sengupta S. The pathology of tumour and “tumour-like” lesions of bone in the University Hospital Kuala Lumpur. Malays J Pathol. 1988;10:45–50.PubMed
6.
go back to reference Sundari SI, Razak MA. Bone and soft tissue sarcoma: an epidemiological study at the National University of Malaysia, 1992–97. J ASEAN Orthop Assoc. 2000;13:31–3. Sundari SI, Razak MA. Bone and soft tissue sarcoma: an epidemiological study at the National University of Malaysia, 1992–97. J ASEAN Orthop Assoc. 2000;13:31–3.
7.
go back to reference Campanacci M, Giunti A, Olmi R. Giant cell tumours of bone—a study of 209 cases with long term follow up in 130. Ital J Orthop Traumatol. 1975;1:249–77. Campanacci M, Giunti A, Olmi R. Giant cell tumours of bone—a study of 209 cases with long term follow up in 130. Ital J Orthop Traumatol. 1975;1:249–77.
8.
go back to reference Campanacci M, Baldini N, Boriani S, Sudanese A. Giant cell tumour of bone. J Bone Joint Surg Am. 1987;69(1):106–14.PubMed Campanacci M, Baldini N, Boriani S, Sudanese A. Giant cell tumour of bone. J Bone Joint Surg Am. 1987;69(1):106–14.PubMed
9.
go back to reference Dahlin DC. Giant cell tumour of bone: highlight of 407 cases. Am J Radiol. 1985;144:955–60. Dahlin DC. Giant cell tumour of bone: highlight of 407 cases. Am J Radiol. 1985;144:955–60.
10.
go back to reference Goldenberg RR, Campbell CJ, Bongfiglio M. Giant cell tumour of bone. An analysis of 218 cases. J Bone Joint Surg Am. 1960;52:619–64. Goldenberg RR, Campbell CJ, Bongfiglio M. Giant cell tumour of bone. An analysis of 218 cases. J Bone Joint Surg Am. 1960;52:619–64.
11.
go back to reference McDonald DJ, Sim FH, McLeod RA, Dahlin DC. Giant cell tumour of bone. J Bone Joint Surg Am. 1986;68:235–42.PubMed McDonald DJ, Sim FH, McLeod RA, Dahlin DC. Giant cell tumour of bone. J Bone Joint Surg Am. 1986;68:235–42.PubMed
12.
go back to reference Szendroni M. Giant cell tumour of bone. J Bone Joint Surg Br. 2004;86:5–12. Szendroni M. Giant cell tumour of bone. J Bone Joint Surg Br. 2004;86:5–12.
13.
14.
go back to reference Unni KK. Dahlin’s bone tumours: general aspect and data on 11087 cases. 5th ed. Philadelphia: Lippincott-Raven; 1998. Unni KK. Dahlin’s bone tumours: general aspect and data on 11087 cases. 5th ed. Philadelphia: Lippincott-Raven; 1998.
15.
go back to reference Jaffe HL. Tumours and tumorous conditions of bones and joints. Philadelphia: Lea & Febiger; 1958. p. 18–43. Jaffe HL. Tumours and tumorous conditions of bones and joints. Philadelphia: Lea & Febiger; 1958. p. 18–43.
16.
go back to reference Wang HC, Chien SH, Lin GT. Management of grade III giant cell tumour tumours of bones. J Surg Oncol. 2005;92:46–51.PubMedCrossRef Wang HC, Chien SH, Lin GT. Management of grade III giant cell tumour tumours of bones. J Surg Oncol. 2005;92:46–51.PubMedCrossRef
17.
go back to reference Saiz P, Virkus W, Piasecki P, Templeton A, Shott S, Gitelis S. Results of giant cell tumour of bone treated with intralesional excision. Clin Orthop. 2004;424:221–6.PubMedCrossRef Saiz P, Virkus W, Piasecki P, Templeton A, Shott S, Gitelis S. Results of giant cell tumour of bone treated with intralesional excision. Clin Orthop. 2004;424:221–6.PubMedCrossRef
18.
go back to reference Capanna R, Sudanese A, Baldini CM. Phenol as an adjuvant in the control of local recurrence of benign neoplasms of bone treated by curettage. Ital J Orthop Traumatol. 1985;11:381–8.PubMed Capanna R, Sudanese A, Baldini CM. Phenol as an adjuvant in the control of local recurrence of benign neoplasms of bone treated by curettage. Ital J Orthop Traumatol. 1985;11:381–8.PubMed
19.
go back to reference Enneking WF, Dunham W, Gabhardt MC, Mabwar M, Pritchard DJ. A system for the functional evaluation of reconstruction procedures after surgical treatment of tumours of the musculoskeletal system. Clin Orthop. 1993;286:241–6.PubMed Enneking WF, Dunham W, Gabhardt MC, Mabwar M, Pritchard DJ. A system for the functional evaluation of reconstruction procedures after surgical treatment of tumours of the musculoskeletal system. Clin Orthop. 1993;286:241–6.PubMed
20.
go back to reference Marugame T, Katanoda K, Matsuda T, Hirabayashi Y, Kamo K, Ajiki W, Sobue T. The Japan cancer surveillance report: incidence of childhood, bone, penis and testis cancers. Jpn J Clin Oncol. 2007;37(4):319–23.PubMedCrossRef Marugame T, Katanoda K, Matsuda T, Hirabayashi Y, Kamo K, Ajiki W, Sobue T. The Japan cancer surveillance report: incidence of childhood, bone, penis and testis cancers. Jpn J Clin Oncol. 2007;37(4):319–23.PubMedCrossRef
21.
go back to reference Faisham WI, Aminudin MS, Zulmi W, Salzihan MD, Mutum SS. Ki-67 immuno-histochemistry index in stage III giant cell tumor of the bone. J Exp Clin Cancer Res. 2010;29:25.CrossRef Faisham WI, Aminudin MS, Zulmi W, Salzihan MD, Mutum SS. Ki-67 immuno-histochemistry index in stage III giant cell tumor of the bone. J Exp Clin Cancer Res. 2010;29:25.CrossRef
22.
go back to reference Faisham WI, Zulmi W, Halim AS, Biswal BM, Mutum SS, Ezane AM. Aggressive giant cell tumour of bone. Singap Med J. 2006;47(8):679. Faisham WI, Zulmi W, Halim AS, Biswal BM, Mutum SS, Ezane AM. Aggressive giant cell tumour of bone. Singap Med J. 2006;47(8):679.
23.
go back to reference Shih HN, Hsu RW, Sim FH. Excision curettage and allografting of giant cell tumor. World J Surg. 1998;22:432–7.PubMedCrossRef Shih HN, Hsu RW, Sim FH. Excision curettage and allografting of giant cell tumor. World J Surg. 1998;22:432–7.PubMedCrossRef
24.
go back to reference Wada T, Kaya M, Nagoya S, Kawaguchi S, Isu K, Yamashita T, Yamawaki S, Ishii S. Complications associated with bone cementing for treatment of giant cell tumours of bone. J Orthop Sci. 2002;7:194–8.PubMedCrossRef Wada T, Kaya M, Nagoya S, Kawaguchi S, Isu K, Yamashita T, Yamawaki S, Ishii S. Complications associated with bone cementing for treatment of giant cell tumours of bone. J Orthop Sci. 2002;7:194–8.PubMedCrossRef
25.
go back to reference Prosser GH, Baloch KG, Tillman RM, Carter SR, Grimer RJ. Does curettage without adjuvant therapy provide low recurrence rates in giant cell tumours of bone? Clin Orthop Relat Res. 2005;435:211–8.PubMedCrossRef Prosser GH, Baloch KG, Tillman RM, Carter SR, Grimer RJ. Does curettage without adjuvant therapy provide low recurrence rates in giant cell tumours of bone? Clin Orthop Relat Res. 2005;435:211–8.PubMedCrossRef
26.
go back to reference Arbeitsgemeinschaft Knochentumoren. Local recurrence of giant cell tumour of bone after intralesional treatment with and without adjuvant therapy. J Bone Joint Surg Am. 2008;90:1060–7. Arbeitsgemeinschaft Knochentumoren. Local recurrence of giant cell tumour of bone after intralesional treatment with and without adjuvant therapy. J Bone Joint Surg Am. 2008;90:1060–7.
27.
go back to reference Steyern FV, Bauer HCF, Trovik C, Kivioja A, Bergh P, Jorgensen PH, Folleras G, Rydholm A. Treatment of local recurrences of giant cell tumour in long bones after curettage and cementing. A Scandinavian Sarcoma Group Study. J Bone Joint Surg B. 2006;88:531–5.CrossRef Steyern FV, Bauer HCF, Trovik C, Kivioja A, Bergh P, Jorgensen PH, Folleras G, Rydholm A. Treatment of local recurrences of giant cell tumour in long bones after curettage and cementing. A Scandinavian Sarcoma Group Study. J Bone Joint Surg B. 2006;88:531–5.CrossRef
28.
go back to reference Hatano H, Morita T, Kobayashi H, Otsuka H. A ceramic prosthesis for the treatment of tumours of the distal radius. J Bone Joint Surg Br B. 2006;88:1656–8.CrossRef Hatano H, Morita T, Kobayashi H, Otsuka H. A ceramic prosthesis for the treatment of tumours of the distal radius. J Bone Joint Surg Br B. 2006;88:1656–8.CrossRef
29.
go back to reference Ihara K, Doi K, Sakai K, Yasamoto M, Kanchiku T, Kavvoi S. Vascularised fibular graft after excision of giant cell tumor of the distal radius. A case report. J Surg Oncol. 1998;68(2):100–3.CrossRef Ihara K, Doi K, Sakai K, Yasamoto M, Kanchiku T, Kavvoi S. Vascularised fibular graft after excision of giant cell tumor of the distal radius. A case report. J Surg Oncol. 1998;68(2):100–3.CrossRef
30.
go back to reference Pho RW. Malignant giant cell tumour of the distal end of radius treated by a free vascularised fibular transplant. J Bone Joint Surg Am. 1981;63:877–84.PubMed Pho RW. Malignant giant cell tumour of the distal end of radius treated by a free vascularised fibular transplant. J Bone Joint Surg Am. 1981;63:877–84.PubMed
31.
go back to reference Cheng C-Y, Shih H-N, Hsu K-Y, Hsu RWW. Treatment of giant cell tumour of the distal radius. Clin Orthop Relat Res. 2001;383:221–8.PubMedCrossRef Cheng C-Y, Shih H-N, Hsu K-Y, Hsu RWW. Treatment of giant cell tumour of the distal radius. Clin Orthop Relat Res. 2001;383:221–8.PubMedCrossRef
32.
go back to reference Harness NG, Mankin HJ. Giant cell tumour of the distal forearm. J Hand Surg (Am). 2004;29(2):188–93.CrossRef Harness NG, Mankin HJ. Giant cell tumour of the distal forearm. J Hand Surg (Am). 2004;29(2):188–93.CrossRef
33.
go back to reference Krieg AH, Hefti F. Reconstruction with nonvascularised fibular grafts after resection of bone tumours. J Bone Joint Surg Br. 2007;89:B:215–21. Krieg AH, Hefti F. Reconstruction with nonvascularised fibular grafts after resection of bone tumours. J Bone Joint Surg Br. 2007;89:B:215–21.
34.
go back to reference Deheshi BM, Jaffer SN, Griffin AM, Ferguson PC, Bell RS, Wunder JS. Joint salvage for pathologic fracture of giant cell tumour of the lower extremity. Clin Orthop Relat Res. 2007;459:96–104.PubMedCrossRef Deheshi BM, Jaffer SN, Griffin AM, Ferguson PC, Bell RS, Wunder JS. Joint salvage for pathologic fracture of giant cell tumour of the lower extremity. Clin Orthop Relat Res. 2007;459:96–104.PubMedCrossRef
Metadata
Title
Giant cell tumour of bone: an analysis of 139 Indian patients
Authors
Kabul Chandra Saikia
Sanjeev Kumar Bhuyan
Munin Borgohain
Swapna Pran Saikia
Anjan Bora
Firoz Ahmed
Publication date
01-09-2011
Publisher
Springer Japan
Published in
Journal of Orthopaedic Science / Issue 5/2011
Print ISSN: 0949-2658
Electronic ISSN: 1436-2023
DOI
https://doi.org/10.1007/s00776-011-0033-7

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