Does pathological fracture affect the rate of local recurrence in patients with a giant cell tumour of bone?: a meta-analysis.

Abstract

We investigated whether the presence of a pathological fracture increased the risk of local recurrence in patients with a giant cell tumour (GCT) of bone. We also assessed if curettage is still an appropriate form of treatment in the presence of a pathological fracture. We conducted a comprehensive review and meta-analysis of papers which reported outcomes in patients with a GCT with and without a pathological fracture at presentation. We computed the odds ratio (OR) of local recurrence in those with and without a pathological fracture. We selected 19 eligible papers for final analysis. This included 3215 patients, of whom 580 (18.0%) had a pathological fracture. The pooled OR for local recurrence between patients with and without a pathological fracture was 1.05 (95% confidence interval (CI) 0.66 to 1.67, p = 0.854). Amongst the subgroup of patients who were treated with curettage, the pooled OR for local recurrence was 1.23 (95% CI 0.75 to 2.01, p = 0.417). A post hoc sample size calculation showed adequate power for both comparisons. There is no difference in local recurrence rates between patients who have a GCT of bone with and without a pathological fracture at the time of presentation. The presence of a pathological fracture should not preclude the decision to perform curettage as carefully selected patients who undergo curettage can have similar outcomes in terms of local recurrence to those without such a fracture.

• Authors: A A Salunke, Y Chen, X Chen, J H Tan, G Singh, B C Tai, L W Khin, M E Puhaindran
• Journal: The bone & joint journal (Bone Joint J) Vol. 97-B Issue 11 Pg. 1566-71 (Nov 2015) ISSN: 2049-4408 [Electronic] England
• PMID: 26530662 (Publication Type: Journal Article, Meta-Analysis)
• Copyright: ©2015 The British Editorial Society of Bone & Joint Surgery.

Topics

• Bone Neoplasms (complications, epidemiology, surgery)
• Curettage
• Fractures, Spontaneous (epidemiology, etiology)
• Giant Cell Tumor of Bone (complications, epidemiology, surgery)
• Humans
• Neoplasm Recurrence, Local (epidemiology, etiology)
• Prognosis
• Risk Factors