Epidemiology of benign giant cell tumor of bone in the Chinese population

Liede, Alexander; Hernandez, Rohini K.; Tang, En-Tzu; Li, Chuang; Bennett, Brian M.; Wong, Steven S.; Jandial, Danielle

doi:10.1016/j.jbo.2018.07.003

Cited by 19 publications

(17 citation statements)

References 20 publications

(34 reference statements)

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“…4,7 In most of the studies from China and Japan, the mean age at presentation ranges from 30.5 to 35.7 years. 8 Similarly, Elshenawy et al in their institutional review of 42 patients had a mean presenting age of 32.3 years. 9 Our mean presenting age of 31.5 years is consistent with these studies.…”

Section: Discussionmentioning

confidence: 92%

Giant Cell Tumor of Bone: 6 Years Institutional Retrospective Review

Ali

Nabi

Shah

et al. 2020

International Journal of Recent Surgical and Medical Sciences

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Introduction Surgery is the cornerstone for the management of giant cell tumors (GCTs). There are no definite guidelines for the management. The purpose of this series was to study the patient demography and results of the surgical intervention for skeletal GCTs in our population. Materials and Methods All the histologically diagnosed cases of GCT of bone from year 2012 to 2018 were retrospectively analyzed for patient demographics, site, and grade of the lesion, type of biopsy taken (if any), nature of surgical intervention, and final outcome with respect to complications. Results Seventeen cases of skeletal GCT were diagnosed on histopathology. The mean age at presentation was 31.5 ± 10.9 years with females affected 1.4 times more. Proximal tibia was the most common site (29.4%) followed by distal radius and distal femur in that order. About 58.8% of the lesions were of Campanacci grade 2 and remaining were grade 3 lesions. Ten patients had extended curettage, five had en bloc resection, and one had amputation as the primary treatment. Twenty percent patients (n = 3) had local recurrence of the pathology and one patient developed distant recurrence (lung metastasis). Conclusion Proximal tibia followed by distal radius was the most common site of GCT in our population. The tumor behavior and recurrence cannot be predicted with any grading system. The goal should be salvage of the joint by intralesional curettage, with resection reserved for distal radius GCTs, cases with extensive soft tissue extension or those with destruction of the articular cartilage and joint involvement.

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Section: Discussionmentioning

confidence: 92%

Giant Cell Tumor of Bone: 6 Years Institutional Retrospective Review

Ali

Nabi

Shah

et al. 2020

International Journal of Recent Surgical and Medical Sciences

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“…Our study has several strength:1. Due to the rare incidence (1-1.5 per million) [14] of giant cell tumor and the fact that denosumab has only been introduced to treating giant cell tumor for nearly a decade, there has been limited number of studies and cases reported on this issue. Our analysis gathered existing and valuable information to conduct a quantitative analysis with a relatively large number of cases involved.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of giant cell tumor of bone is quite low, reported incidence included 1.38 per million in US, 1.49 per million in China [14]. Considering the rare incidence and the fact that denosumab has only been approved by FDA for 6 years, most studies investigating on this subject are retrospective studies with small cohort.…”

Section: Introductionmentioning

confidence: 99%

Pre-operative denosumab is associated with higher risk of local recurrence in giant cell tumor of bone: a systematic review and meta-analysis

Chen

Zhu

et al. 2020

BMC Musculoskelet Disord

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Background: In 2013, denosumab was introduced as peri-operative adjuvant treatment for giant cell tumor (GCT) of bone as it inhibits osteoclast activity. It is suggested that denosumab relives pain, facilitate curettage in lesions requiring resection initially. However, controversy remains whether denosumab increases the risk of local recurrence after surgery. Methods: Medline, Embase and the Cochrane Library were comprehensively searched in June 2019 to identify studies investigating the clinical outcome of GCT of bone with and without peri-operative denosumab after surgery. Data were gathered and a meta-analysis was conducted. Result: Ten studies with 1082 cases (169 in denosumab group, 913 in control group) were included. Overall, denosumab was associated with significantly higher risk of recurrence(P < 0.02) and inferior 5 year recurrence free survival(P = 0.000). Denosumab and curettage has a relatively higher risk of recurrence comparing to curettage alone(P = 0.07). The risk of recurrence is not significantly increased if denosumab was administered both preoperatively and postoperatively(P = 0.24). Conclusion: Administration of denosumab is associated with increased risk of recurrence due to a variety of reasons, though it is proven effective in relieving pain, enabling curettage and improved functional outcome. Postoperative denosumab is recommended as it continuously suppress/eliminate residue tumor cells.

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“…Giant cell tumor is commonly diagnosed in patients between 20 and 45 years of age. [1][2][3][7][8][9]39 Although few patients in this series (3/25) were diagnosed during the second decade of life, most patients (15/25) were diagnosed during their third and fourth decades.…”

Section: Discussionmentioning

confidence: 99%

Giant cell tumor of bone: Unusual features of a rare tumor

et al. 2019

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Giant cell tumor of bone is a benign tumor with an aggressive behavior. Its typical subarticular location and high recurrence risk can be associated with significant morbidity. Although benign, it can rarely metastasize especially to the lungs. Also, it can be multicentric in less than 1% of patients. Late malignant transformation, although rare, can occur with a very poor prognosis. This series reports on these unusual and challenging features and management considerations of giant cell tumor of bone. This retrospective study included review of the medical records of patients with a confirmed histopathological diagnosis of giant cell tumor of bone. A total of 25 patients (16 females and 9 males) with a mean age of 34.5 years were included; 22 had primary tumors, while 3 were referred with recurrent tumors. Pain was the most common presenting symptom. Most patients had grade III tumors. Tumors around the knee were the most common. Multicentric tumors were detected in three patients. Twenty-three patients (20 primary giant cell tumor of bone and 3 with recurrence) received treatment. Most patients (15/23) were treated with intralesional curettage with or without adjuvants. Seven patients had wide excision. Recurrence was seen in 45% (9/20) of primary giant cell tumor of bone especially with difficult anatomical locations. Most recurrences occurred more than 4 years after treatment. Pulmonary nodules were detected in four patients; two of them showed resolution during follow-up. One patient developed secondary sarcoma transformation with a fatal outcome. Giant cell tumor of bone was more common in females. Long bones were more affected, especially around the knee. Intralesional curettage was the most frequently used treatment. Recurrence was associated with inadequate tumor resection (especially in difficult anatomical location), younger age, male gender, and advanced local tumor grade. Denosumab can be used in the treatment of pulmonary metastasis, multicentric and recurrent giant cell tumor of bone. Due to late recurrence and malignant transformation, a prolonged follow-up is warranted.

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Epidemiology of benign giant cell tumor of bone in the Chinese population

Abstract: HighlightsGCT is a rare disease in China with an annual incidence rate of one to three per million persons in the population.This incidence rate is somewhat higher than in Japan or the U.S. which likely reflects a younger population in China.

Cited by 19 publications

References 20 publications

Giant Cell Tumor of Bone: 6 Years Institutional Retrospective Review

Giant Cell Tumor of Bone: 6 Years Institutional Retrospective Review

Pre-operative denosumab is associated with higher risk of local recurrence in giant cell tumor of bone: a systematic review and meta-analysis

Giant cell tumor of bone: Unusual features of a rare tumor

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