Microwave in situ inactivation technique for the treatment of giant cell tumor of bone: a systematic review and meta-analysis

Introduction: Giant cell tumor of bone (GCTB) necessitates a distinct treatment approach compared to benign and malignant bone tumors due to its invasive nature. Intralesional curettage, with adequate margin control, is an established and effective treatment option that is widely accepted. The efficacy of microwave in situ inactivation (MIST) or microwave ablation (MWA) technology, which is commonly used as an adjuvant, needs to be evaluated. The objective of this study was to systematically review the treatment options of microwave in situ inactivation for GCTB. Materials: and methods A systematic review of published literature was conducted to analyze the treatment of giant cell tumor of bone with microwave ablation. The literature search was performed using various online databases such as EMBASE, the Cochrane Library, PubMed, Web of Science, and Medline. The effectiveness of MIST in treating GCTB and any associated complications were evaluated through the summary of the literature. Results: The included literature presents findings from five studies, which collectively reported a total of 221 cases. The effectiveness of MIST was assessed in terms of the Musculoskeletal Tumor Society (MSTS) score over an average 18-month follow-up period. The results showed a significant improvement, with a mean difference of 26.65 (95% CI: 24.91–28.39, p < 0.00001). Subgroup analysis specifically focusing on distal femur and distal radius lesions demonstrated excellent outcomes with satisfactory control of overall complications. Conclusions: Existing evidence suggests that the combination of MIST and effective intralesional curettage achieves satisfactory short-to-medium-term treatment outcomes for giant cell tumors of the bone. This approach offers significant advantages in key aspects, including postoperative mobility and preservation of joint function, control of local recurrence, prevention of joint degeneration, and reduction in metastasis and mortality rates.