GIANT CELL TUMOR OF BONE: A MULTICENTER EPIDEMIOLOGICAL STUDY IN BRAZIL.

IF 0.5 4区 医学 Q4 ORTHOPEDICS Acta Ortopedica Brasileira Pub Date : 2024-03-22 eCollection Date: 2024-01-01 DOI:10.1590/1413-785220243201e273066
Ricardo Gehrke Becker, Carlos Roberto Galia, Julie Francine Cerutti Santos Pestilho, Bruno Pereira Antunes, André Mathias Baptista, Alex Guedes
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Abstract

Introduction: Giant cell tumor of bone (GCTB) mainly affects young adults' long bone epiphyses, threatening bone strength and joint function. Surgery is the primary treatment, although post-surgery recurrence is significant. This study analyzes patient profiles, treatments, and outcomes for GCTB in Brazil.

Methods: We retrospectively assessed local recurrence, metastasis, and treatment approaches in 643 GCTB patients across 16 Brazilian centers (1989-2021), considering regional differences.

Results: 5.1% (n=33) developed pulmonary metastases, 14.3% (n=92) had pathological fractures, and the local recurrence rate was 18.2% (n=114). Higher rates of pulmonary metastases (12.1%) and advanced tumors (Campanacci III, 88.9%) were noted in lower-income North and Northeast regions. The North also had more pathological fractures (33.3%), extensive resections (61.1%), and amputations (27.8%). These regions faced longer surgical delays (36-39 days) than the South and Southeast (27-33 days).

Conclusions: Our findings corroborate international data, underscoring regional disparities in Brazil that may lead to worse outcomes in disadvantaged areas. This highlights the need for improved orthopedic oncology care in Brazil's economically and structurally challenged regions. Level of Evidence III; Retrospective Cohort.

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骨巨细胞瘤:巴西多中心流行病学研究。
导言骨巨细胞瘤(GCTB)主要影响青壮年的长骨骺,威胁骨强度和关节功能。手术是主要的治疗方法,但术后复发率很高。本研究分析了巴西 GCTB 患者的情况、治疗方法和结果:我们回顾性评估了巴西16个中心(1989-2021年)643例GCTB患者的局部复发、转移和治疗方法,并考虑了地区差异:5.1%(33人)发生肺转移,14.3%(92人)发生病理性骨折,局部复发率为18.2%(114人)。收入较低的北部和东北部地区肺转移率(12.1%)和晚期肿瘤率(Campanacci III,88.9%)较高。北部地区的病理骨折率(33.3%)、大面积切除率(61.1%)和截肢率(27.8%)也较高。这些地区的手术延迟时间(36-39 天)比南部和东南部(27-33 天)更长:我们的研究结果证实了国际数据,强调了巴西的地区差异,这可能导致贫困地区的治疗效果更差。这凸显了在巴西经济和结构面临挑战的地区改善骨科肿瘤治疗的必要性。证据等级 III;回顾性队列。
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来源期刊
CiteScore
0.90
自引率
14.30%
发文量
67
审稿时长
25 weeks
期刊介绍: A Revista Acta Ortopédica Brasileira, órgão oficial do Departamento de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo (DOT/FMUSP), é publicada bimestralmente em seis edições ao ano (jan/fev, mar/abr, maio/jun, jul/ago, set/out e nov/dez) com versão em inglês disponível nos principais indexadores nacionais e internacionais e instituições de ensino do Brasil. Sendo hoje reconhecidamente uma importante contribuição para os especialistas da área com sua seriedade e árduo trabalho para as indexações já conquistadas.
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