Clinical Outcomes of Curettage versus Surgical Resection of Giant Cell Tumor of the Distal Radius - A Systematic Review and Meta-analysis.

Objective  Surgical procedures of curettage and surgical resection are used to treat giant cell tumor (GCT) of the distal radius, but it is still controversial whether one provides better functional outcomes than the other. The present study aims to determine and compare both procedures regarding complications, local recurrence, and mobility. Methods  A complete search of the applicable literature was done and independently assessed by three authors. Included studies reported on patients who were surgically treated for GCT of the distal radius with either curettage or surgical resection. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement was used to obtain research regarding outcomes of surgical resection and curettage for GCT of the distal radius. A meta-analysis was performed using this data. Quality assessment was performed. Results  Seven studies, comprising 114 patients with resection and 108 with curettage, totaling 222 subjects with 117 males and 105 females, were included in the present review. Overall, patients in the curettage group had a higher recurrence rate (0.205; 95% confidence interval [95%CI] = 0.057-0.735; p  = 0.015). Incidences in complications remains the same in both groups (2.845; 95%CI = 0.644-12.57; p  = 0.168). Incidences in functional outcomes were the same in both groups as well (-0.948; 95%CI = -2.074-0.178; p  = 0.099). Conclusion  The authors prefer resection and reconstruction for GCT of distal radius as optimum treatment method due to the similar functional outcomes and lower chances of recurrence. Curettage might be a treatment option in low-grade GCT coupled with adjuvant, neoadjuvant or ablation to reduce the risk of recurrence.