Giant cell tumor of bone: A single center study of 115 cases
Background: Giant cell tumor of bone (GCTB) is a locally aggressive bone tumor that represents about 4–5% of all primary bone tumors. It is characterized by aggressive growth, possible recurrence after surgical treatment and, in rare cases, metastasis. Surgical management is the primary treatment an...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-04-01
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| Series: | Journal of Bone Oncology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2212137422000070 |
| _version_ | 1818248800443039744 |
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| author | Niklas Deventer Tymoteusz Budny Georg Gosheger Anna Rachbauer Jan Puetzler Jan Christoph Theil Dmytrii Kovtun Marieke de Vaal Nils Deventer |
| author_facet | Niklas Deventer Tymoteusz Budny Georg Gosheger Anna Rachbauer Jan Puetzler Jan Christoph Theil Dmytrii Kovtun Marieke de Vaal Nils Deventer |
| author_sort | Niklas Deventer |
| collection | DOAJ |
| description | Background: Giant cell tumor of bone (GCTB) is a locally aggressive bone tumor that represents about 4–5% of all primary bone tumors. It is characterized by aggressive growth, possible recurrence after surgical treatment and, in rare cases, metastasis. Surgical management is the primary treatment and may include intralesional curettage with adjuvants or, in rare cases, wide resection. In recent years the monoclonal antibody denosumab has been introduced as a potential (neo-)adjuvant systemic treatment option for patients with borderline resectable or unresectable lesions. Currently several studies reported that the use of denosumab prior to curettage possibly increase the risk of local recurrence. Methods: In this retrospective study we reviewed 115 cases of GCT with a mean follow-up of 65.6 (24–404) months who underwent a surgical treatment with or without preoperative denosumab therapy in our institution. Potential risk factors for LR and complications were analyzed. Results: The study includes 47 male (40.9%) and 68 female (59.1%) patients with a mean age of 33.9 (10–77) years and a mean follow-up of 65.6 (24–404) months. Denosumab was used in 33 (28.7%) cases, in 14 cases (12.2%) in a neoadjuvant setting and in 17 cases preoperatively before re-curettage (14.8%) after LR. In 105 cases (91.3%) an intralesional curettage was performed. The overall LR rate was 47.8% (55 cases). Patients who underwent intralesional curettage and bone cement augmentation without neoadjuvant denosumab treatment had LR in 42.2% (38/90) of the cases. Patients who underwent neoadjuvant denosumab treatment prior to curettage had LR in 28.6% (4/14). Re-recurrence was frequent in patients with neoadjuvant denosumab treatment who had LR after initial curettage (50%, 8/16). After wide resection and endoprosthetic replacement one case (20%) of local recurrence was detectable (1/5 cases). Conclusions: GCTB recurs frequently after intralesional curettage and cement augmentation. While denosumab is a potential (neo-)adjuvant treatment option that might be used for lesions that are difficult to resect, surgeons should be aware that LR is still frequent. |
| first_indexed | 2024-12-12T15:26:21Z |
| format | Article |
| id | doaj.art-1bcbe2543a784939918b02fcfd6ac461 |
| institution | Directory Open Access Journal |
| issn | 2212-1374 |
| language | English |
| last_indexed | 2024-12-12T15:26:21Z |
| publishDate | 2022-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Bone Oncology |
| spelling | doaj.art-1bcbe2543a784939918b02fcfd6ac4612022-12-22T00:20:14ZengElsevierJournal of Bone Oncology2212-13742022-04-0133100417Giant cell tumor of bone: A single center study of 115 casesNiklas Deventer0Tymoteusz Budny1Georg Gosheger2Anna Rachbauer3Jan Puetzler4Jan Christoph Theil5Dmytrii Kovtun6Marieke de Vaal7Nils Deventer8Department of Orthopedics and Tumororthopedics, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany; Corresponding author.Department of Orthopedics and Tumororthopedics, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, GermanyDepartment of Orthopedics and Tumororthopedics, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, GermanyDepartment of Orthopedics and Tumororthopedics, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, GermanyDepartment of Orthopedics and Tumororthopedics, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, GermanyDepartment of Orthopedics and Tumororthopedics, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, GermanyDepartment of Orthopedics and Tumororthopedics, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, GermanyDepartment of Orthopedics and Tumororthopedics, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, GermanyDepartment of General Paediatrics, University Children's Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, GermanyBackground: Giant cell tumor of bone (GCTB) is a locally aggressive bone tumor that represents about 4–5% of all primary bone tumors. It is characterized by aggressive growth, possible recurrence after surgical treatment and, in rare cases, metastasis. Surgical management is the primary treatment and may include intralesional curettage with adjuvants or, in rare cases, wide resection. In recent years the monoclonal antibody denosumab has been introduced as a potential (neo-)adjuvant systemic treatment option for patients with borderline resectable or unresectable lesions. Currently several studies reported that the use of denosumab prior to curettage possibly increase the risk of local recurrence. Methods: In this retrospective study we reviewed 115 cases of GCT with a mean follow-up of 65.6 (24–404) months who underwent a surgical treatment with or without preoperative denosumab therapy in our institution. Potential risk factors for LR and complications were analyzed. Results: The study includes 47 male (40.9%) and 68 female (59.1%) patients with a mean age of 33.9 (10–77) years and a mean follow-up of 65.6 (24–404) months. Denosumab was used in 33 (28.7%) cases, in 14 cases (12.2%) in a neoadjuvant setting and in 17 cases preoperatively before re-curettage (14.8%) after LR. In 105 cases (91.3%) an intralesional curettage was performed. The overall LR rate was 47.8% (55 cases). Patients who underwent intralesional curettage and bone cement augmentation without neoadjuvant denosumab treatment had LR in 42.2% (38/90) of the cases. Patients who underwent neoadjuvant denosumab treatment prior to curettage had LR in 28.6% (4/14). Re-recurrence was frequent in patients with neoadjuvant denosumab treatment who had LR after initial curettage (50%, 8/16). After wide resection and endoprosthetic replacement one case (20%) of local recurrence was detectable (1/5 cases). Conclusions: GCTB recurs frequently after intralesional curettage and cement augmentation. While denosumab is a potential (neo-)adjuvant treatment option that might be used for lesions that are difficult to resect, surgeons should be aware that LR is still frequent.http://www.sciencedirect.com/science/article/pii/S2212137422000070Giant cell tumorGiant cell tumor of boneIntralesional curettageDenosumab |
| spellingShingle | Niklas Deventer Tymoteusz Budny Georg Gosheger Anna Rachbauer Jan Puetzler Jan Christoph Theil Dmytrii Kovtun Marieke de Vaal Nils Deventer Giant cell tumor of bone: A single center study of 115 cases Journal of Bone Oncology Giant cell tumor Giant cell tumor of bone Intralesional curettage Denosumab |
| title | Giant cell tumor of bone: A single center study of 115 cases |
| title_full | Giant cell tumor of bone: A single center study of 115 cases |
| title_fullStr | Giant cell tumor of bone: A single center study of 115 cases |
| title_full_unstemmed | Giant cell tumor of bone: A single center study of 115 cases |
| title_short | Giant cell tumor of bone: A single center study of 115 cases |
| title_sort | giant cell tumor of bone a single center study of 115 cases |
| topic | Giant cell tumor Giant cell tumor of bone Intralesional curettage Denosumab |
| url | http://www.sciencedirect.com/science/article/pii/S2212137422000070 |
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