Risk factors for pulmonary metastases from giant cell tumor of bone.
BACKGROUND
Giant cell tumor (GCT) of bone is a rare, benign, aggressive bone tumor with an unusual capacity to metastasize to the lung. It was the goal of this study to identify patient and treatment-specific variables associated with the development of pulmonary metastases of GCT of bone.


METHODS
From 1980 to 2009, 291 patients with benign GCT of bone were treated at our institution, and 167 were followed for at least two years. Eleven (6.6%) of these 167 patients developed biopsy-confirmed pulmonary metastasis. All patients were evaluated relative to nine patient, disease, and treatment-specific variables.


RESULTS
We identified four properties of benign GCT of bone associated with an increased risk of metastasis on univariate analysis: age at diagnosis, axial location of the primary GCT, primary Enneking stage-3 disease, and local recurrence. Multivariate analysis showed local recurrence to be an independent risk factor for pulmonary metastasis (adjusted odds ratio, 7.42).


CONCLUSIONS
There is an increased risk of pulmonary metastasis of GCT of bone in patients who are younger, present with Enneking stage-3 disease, develop local recurrence, and/or present with axial disease. The mode of treatment was not found to be associated with the development of pulmonary metastasis.
Department of Orthopaedics and Rehabilitation, University of Florida, 3450 Hull Road, Gainesville, FL 32607. E-mail address for C.M. Chan: chancm@ortho.ufl.edu.
Chung Ming
CM
Chan
Newport Orthopaedic Institute, 22 Corporate Plaza Drive, Newport Beach, CA 92660.
Zachary
Z
Adler
Department of Orthopaedics and Rehabilitation, University of Florida, 3450 Hull Road, Gainesville, FL 32607. E-mail address for C.M. Chan: chancm@ortho.ufl.edu.
John D
JD
Reith
Department of Orthopaedics and Rehabilitation, University of Florida, 3450 Hull Road, Gainesville, FL 32607. E-mail address for C.M. Chan: chancm@ortho.ufl.edu.
C Parker
CP
Gibbs
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D001859:Bone Neoplasms / Q000453:epidemiology* / Q000473:pathology; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D018212:Giant Cell Tumor of Bone / Q000453:epidemiology* / Q000556:secondary*; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult