Treatment of giant cell tumor of bone: a comparison of local curettage and wide resection.

BACKGROUND: Giant cell tumor of bone is benign but locally aggressive neoplasm with a tendency for local recurrence. Although various treatment options have been utilized and reported, it remains a difficult therapeutic problem for the orthopedic surgeon.
METHODS: We reviewed the results of the treatment of giant cell tumor of bone in 27 patients. Eleven patients were treated with extended curettage and burring then packing with cement, while 16 patients had wide resection and reconstruction.
RESULTS: At an average of 50 months after surgery, the recurrence rate of curettage was 27% and that of wide resection was 6.25%. Two of the three patients who had a recurrence after curettage were treated by a secondary curettage procedure and were later free of disease. Overall, the local control rate after second curettage and packing with cement was 90.9%. There was no infection in the curettage group but infection occurred in 3 patients of the resection group. Eight patients in the curettage group (80%) had an excellent functional result but only 2 patients in the resection group (13%) achieved an excellent result.
CONCLUSION: This study demonstrates that either curettage and packing with cement or wide resection are effective in treatment of giant cell tumor of bone. There is, however, a better functional result after curettage and packing with cement than following wide resection. We recommend curettage and cement packing for giant cell tumor of bone whenever it is technically feasible.