Bone Tumor Diagnosis and Treatments Open access Peer reviewed

Age-Related Differences in Surgical Management of Giant Cell Tumor of Bone: A Nationwide Registry Analysis

Hitomi Hara, Akira Kawai, Naomasa Fukase, R. Sawada and 4 more

Formosan Journal of Surgery | Sep 5, 2026

Abstract

Abstract

Background: Giant cell tumor of bone (GCTB) rarely affects elderly individuals, and its clinical characteristics in this population remain insufficiently defined. This study aimed to investigate epidemiologic features and age-related differences in the surgical management of GCTB using a nationwide registry. Methods: Patients with histologically confirmed benign GCTB recorded in the Japanese Bone and Soft Tissue Tumor (BSTT) Registry between 2006 and 2019 were analyzed. Clinical characteristics, treatment patterns, and postoperative outcomes were compared among peak-incidence (20–45 years), middle-aged (46–64 years), and elderly (≥65 years) groups. Results: Among 1,978 eligible cases, 173 patients (8.7%) were aged 65 years or older. Surgical intervention decreased with increasing age and was lowest in the elderly group (88%, 80%, and 75%, respectively; p < 0.001). After 2014, the proportion of elderly patients undergoing surgery declined significantly from 85% to 66% (p = 0.005). When surgery was performed, elderly patients more frequently underwent marginal or wide resection, whereas intralesional curettage predominated in younger adults. Conclusions: This nationwide registry analysis demonstrates age-related differences in the surgical management of GCTB. Although the proportion of patients undergoing surgery decreased after 2014, causal relationships with denosumab approval cannot be established in this registry-based study. Reduced use of surgery did not necessarily imply less extensive surgical management among patients who underwent surgery. These findings support individualized, age-sensitive treatment strategies.

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Authors

Researchers on this paper

Hitomi Hara

first | Kobe University

Akira Kawai

middle

Naomasa Fukase

middle | Kobe University | ORCID 0000-0001-5688-7673

R. Sawada

middle | Kobe University | ORCID 0000-0002-3131-3777

Toshiyuki Takemori

middle | Kobe University

Yuta Nakamatsu

middle | Kobe University

Ryosuke Kuroda

middle | Kobe University

Toshihiro Akisue

last | Kobe University | ORCID 0000-0003-3708-4095

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Citation

BibTeX

@article{Hara2026Related,
  title = {Age-Related Differences in Surgical Management of Giant Cell Tumor of Bone: A Nationwide Registry Analysis},
  author = {Hitomi Hara and Akira Kawai and Naomasa Fukase and R. Sawada and Toshiyuki Takemori and Yuta Nakamatsu and Ryosuke Kuroda and Toshihiro Akisue},
  journal = {Formosan Journal of Surgery},
  year = {2026},
  doi = {10.1097/fs9.0000000000000303},
  url = {https://doi.org/10.1097/fs9.0000000000000303}
}

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