Objective To investigate the relationship between the characteristics and postoperative recurrence of giant cell tumor (GCT) of bone.

Methods A total of 451 patients followed up with GCT of bone undergoing surgical treatment were reviewed to analyze the association of the characteristics, including tumor location, operation method, Campanacci grade, pathological fracture and pulmonary metastasis, with the recurrence rate of GCT bone.

Results The recurrence rate of GCT in the spine or pelvis was significantly higher than that around the knee (P < 0.001), in distal radius (P=0.005) and in other parts (P < 0.001). The recurrence rate of grade Ⅲ GCT after simple excochleation was significantly higher than that after enlarged excochleation (P < 0.001) and tumor segment or block resection (P=0.002). The recurrence rate of GCT undergoing simple excochleation among cases of Campanacci gradeⅠ, Ⅱ and Ⅲ was significantly different (P=0.028); however, for GCT undergoing enlarged excochleation and tumor segment or block resection, there was no statistically significant difference of the recurrence rate between cases of gradeⅡ and Ⅲ (P > 0.05). The pulmonary metastasis rate in the recurrence cases of GCT was significantly higher than that in no recurrence cases (P < 0.001). There was no statistically significant difference of the recurrence rate of GCT between cases with and without pathological fracture (P > 0.05).

Conclusion The surgical procedure affects the surgical boundary of GCT, which is closely related to the postoperative recurrence rate; the pulmonary metastasis rate of recurrent cases is significantly increased; adequate surgical boundaries for the surgical treatment of GCT may be essential to improve the prognosis of patients with GCT.