Becker Ricardo Gehrke, Galia Carlos Roberto, Pestilho Julie Francine Cerutti Santos, Antunes Bruno Pereira, Baptista André Mathias, Guedes Alex
Hospital de Clínicas de Porto Alegre (HCPA), Department of Orthopedics and Trauma, Porto Alegre, RS, Brazil.
Instituto do Câncer Infantil, Porto Alegre, RS, Brazil.
Acta Ortop Bras. 2024 Mar 22;32(1):e273066. doi: 10.1590/1413-785220243201e273066. eCollection 2024.
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.
We retrospectively assessed local recurrence, metastasis, and treatment approaches in 643 GCTB patients across 16 Brazilian centers (1989-2021), considering regional differences.
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).
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.
骨巨细胞瘤（GCTB）主要影响年轻成年人的长骨骨骺，威胁骨骼强度和关节功能。手术是主要治疗方法，尽管术后复发率较高。本研究分析了巴西GCTB患者的病例资料、治疗方法及治疗结果。
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、转移及治疗方法，并考虑了地区差异。
5.1%（n = 33）发生肺转移，14.3%（n = 92）发生病理性骨折，局部复发率为18.2%（n = 114）。在低收入的北部和东北部地区，肺转移率较高（12.1%），高级别肿瘤（坎帕纳奇III级，88.9%）更为常见。北部地区病理性骨折更多（33.3%），广泛切除（61.1%）和截肢（27.8%）的比例也更高。与南部和东南部地区（27 - 33天）相比，这些地区手术延迟时间更长（36 - 39天）。
我们的研究结果证实了国际数据，强调了巴西存在地区差异，这可能导致贫困地区的治疗结果更差。这凸显了在巴西经济和结构上面临挑战的地区改善骨肿瘤治疗的必要性。
