Chromosomal abnormalities associated with local recurrence or pulmonary metastasis of giant cell tumor of bone in Thai adults: a prospective cohort study with 6 years of follow-up

Abstract

Background: Giant cell tumor (GCT) of bone demonstrates chromosomal abnormalities. This study aimed to investigate the prognostic role of chromosomal abnormalities of primary GCT of bone relative to local recurrence or pulmonary metastasis.
Methods: This prospective longitudinal cohort study with 6 years of follow-up included consecutive patients with primary GCT of bone that were surgically treated during 2011 to 2013 at the Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. All patients underwent surgical resection with extended intralesional curettage and phenol local adjuvant therapy. Systematic cytogenetic analysis compared cytogenetic abnormalities between patients with and without local recurrence or pulmonary metastasis. Fifteen patients were eligible, enrolled, and had successful cytogenetic analysis.
Results: The median follow-up time was 46 months (interquartile range [IQR]: 32-58). Five patients experienced local recurrence or pulmonary metastasis with a median time to recurrence of 6 months (IQR: 3.25-10.5). The mean number of abnormal cells in the primary culture compared between those with local recurrence or pulmonary metastasis and those without was 24.4 vs. 9.6 cells, respectively (p=0.04). A similar pattern was observed in the cultures of the subsequent four passages (all p<0.05). Forty-five patterns of clonal telomeric association (tas) were observed in passaged cultures. Six tas patterns were associated with local recurrence or pulmonary metastasis, including tas(11;19)(p15;q13.4), tas(15;19)(q26.3;q13.4), tas(15;22)(p13;p13), tas(16;19)(p13.3;q13.4), tas(17;19)(p13;q13.4), and tas(19;22)(q13.4;q13).
Conclusions: The mean number of abnormal cells and the six identified TAS patterns may be valuable prognostic factors for local recurrence or pulmonary metastasis of GCT tumor of bone.