The prognosis of giant cell tumor of bone and the vital risk factors that affect its postoperative recurrence: a meta-analysis

BACKGROUND: The purpose of this study is to analyze the overall prognosis of giant cell tumor of bone (GCTB) and the risk factors that affect its postoperative recurrence. METHODS: The databases of PubMed, Cochrane, Web of Science, Embase, China national knowledge infrastructure, China Biology Medicine disc, and Wanfang were searched until 20 June 2020. Following patients, intervention, comparator, outcomes, study design (PICOS) guidelines, eligible articles were defined as studies evaluating the overall prognosis of GCTB and the risk factors that affect its postoperative recurrence. The association between five risk factors (surgical methods, whether there is soft tissue invasion, tumor size, p53 expression, vascular endothelial growth factor (VEGF) expression) and the recurrence of GCTB were calculated using fixed-effects or random-effects models. The heterogeneity of the odd ration (OR) and effect size (ES) of each study was quantified using Cochran’s Q test and Higgins-I2 statistic. The publication bias was analyzed through the drawing of the funnel diagram. RESULTS: A total of 10 studies were included in the study. We found that the probability of recurrence of patients who choose simple curettage is 5.75 times that of patients who choose amputation or total resection. Patients with soft tissue invasion are 3.76 times more likely to relapse than non-invasive GCTB. The probability of recurrence of patients with tumors larger than 5 cm is 2.8 times that of patients with tumors smaller than. Patients with positive expression of p53 are 3.82 times more likely to relapse than patients with negative expression. And patients with positive expression of VEGF are 3.82 times more likely to relapse than patients with negative expression. CONCLUSIONS: In conclusion, our analysis of five risk factors can be used to measure the recurrence of GCTB and provide important preoperative recommendations for patients with GCTB.