Summary
Purpose. To describe and compare the methods of treatment of giant cell tumors overviewed in the scientific literature and their influence on oncological and functional outcomes.
Methods. The literature review was done by using international databases: NCBI, PubMed, ResearchGate, and ScienceDirect. The following keywords were used: curettage, denosumab, giant cell tumor, giant cell tumor of bone, resection. The methods methods of treatment of giant cell tumors were described and compared based on recurrence risk and functional assessment, according to the scale of Musculoskeletal Tumor Society.
Results. Giant cell tumors are non malignant fibroblast tumors of mesenchymal origin, which are mostly made up of large, multinucleated osteoclast-like cells. The selection of optimal treatment method for giant cell tumors is individualized due to the lack of guidelines for standard treatment. Surgical treatment remains the “gold stan dard”. The majority of patients are treated by curettage or resection. Curettage is usually performed for early-stage tumors, but soft tissue involvement and pathological fractures are not contraindications for curettage. Resection is usually recommended for late-stage and anatomically complex tumors. Various surgical adjuvants are used to reduce recurrence rates. All adjuvants are considered to be similarly effective. Despite lower recurrence rates after resection, functional outcomes after curettage are better. The most common reconstructive methods after curettage are cementation or bone graft insertion, and after resection – joint pros thesis or bone graft reconstruction. The optimal choice of re con struc tive technique was viewed differently by various authors. Cement reconstruction results in lower re cur rence rates, whilst bone graft in sertion leads to better functional out comes. Alternative methods of treatment of inoper able giant cell tumors are radio therapy, embolization of tumor feeding blood vessels and systemic therapy with denosumab. The search for targeted therapeutic markers remains a relevant object of scientific study.
