Outcome of re-operation for local recurrence following pre-operative denosumab administration and curettage for giant cell tumour of bone with difficult joint preservation

Tsukamoto, Shinji; Hindiskere, Suraj; Honoki, Kanya; Mavrogenis, Andreas F.; Tanaka, Yasuhito; Chinder, Pramod S.; Donati, Davide María; Errani, Costantino

doi:10.1007/s00264-022-05613-9

Cited by 8 publications

(4 citation statements)

References 40 publications

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“…Its application has been occasionally restricted due to possible systematic complications, including osteonecrosis in the jaw, arthralgia, fatigue, headache, anemia and hypercalcemia [ 43 ]. Tsukamoto et al [ 44 ] administrated denosumab before curettage of GCTB in patients suffering from large extraosseous lesions, pathological fractures or minimal residual periarticular and subchondral bone stock. They identified that preoperative denosumab application was associated with a lower recurrence rate, improved functional score and higher joint preservation rate.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Recurrent Giant Cell Tumor of Bones: A Systematic Review

Pitsilos

Givissis

Papadopoulos

et al. 2023

Cancers

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The giant cell tumor of bones (GCTB) is a benign bone tumor with high postoperative recurrence potential. No specific treatment protocol has been developed to date in case of tumor recurrence, and the kind of re-operative surgery depends upon the surgeon’s preferences. The aim of this systematic review is to determine the second recurrence rate and the respective functional results of the available treatment options applied to recurrent GCTB. Medline/PubMed and Scopus were searched to identify articles published until March 2023. Twelve studies fulfilled the inclusion criteria, comprising 458 patients suffering from recurrent GCTB. The overall incidence of second recurrence was 20.5%, at a mean interval of 28.8 months after the first surgery, and it was more evident after intralesional curettage (IC) surgery than en-bloc resection (EBR) (p = 0.012). In the IC group of patients, the second recurrence rate was lower and the functional outcome was greater when polymethylmethacrylate cement (PMMAc) was used as an adjuvant instead of bone grafting (p < 0.001 for both parameters). Reconstruction of the created bone defect after EBR with a structural allograft provided a better outcome than prosthesis (p = 0.028). According to this systematic review, EBR (first choice) and IC with PMMAc (second choice) are the best treatment options for recurrent GCTB.

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Section: Discussionmentioning

confidence: 99%

Treatment of Recurrent Giant Cell Tumor of Bones: A Systematic Review

Pitsilos

Givissis

Papadopoulos

et al. 2023

Cancers

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“…Denosumab was indicated in patients with minimal residual periarticular and subchondral bone, large tumors (Campanacci stage 3), and pathological fractures that make joint preservation difficult 30 . Preoperatively, denosumab (120 mg) was given subcutaneously once a week for 1 month and then once a month for 2–7 months.…”

Section: Methodsmentioning

confidence: 99%

Giant cell tumor of bone with secondary aneurysmal bone cyst does not have a higher risk of local recurrence

Tsukamoto

Aiba

Righi

et al. 2023

Journal of Surgical Oncology

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Background Fluid–fluid levels (FFLs) is found in 10%–16% of giant cell tumor of bone (GCTB), and the presence of FFLs raises the suspicion of GCTB with secondary aneurysmal bone cyst (ABC), which can lead to increased intraoperative bleeding and, blurring the operative field, be associated with a risk of local recurrence. The first objective of this study is to determine whether secondary ABC is associated with a higher risk of local recurrence after curettage in patients with GCTB of the extremities. The second objective of this study is to investigate the sensitivity, specificity, positive predictive value, and negative predictive value of the presence of FFLs detected on magnetic resonance imaging (MRI) to diagnose secondary ABC associated with GCTB. Methods Two hundred and eighty patients with GCTB of the extremities who underwent curettage at the authors' institutions between 1980 and 2021 were included in this study. Results Secondary ABC was found in 36 of 280 patients (12.9%) and local recurrence occurred in 66 of 280 patients (23.6%). Multivariate analysis showed no significant correlation between secondary ABC and local recurrence (hazard ratio [HR]: 1.87 (95% confidence interval [CI]: 1.00–3.53]; p = 0.051). Preoperative MRI revealed FFLs in 13 of 82 patients (15.9%). Sensitivity, specificity, positive predictive value, and negative predictive value of FFLs detected on preoperative MRI to diagnose secondary ABC were 36.8%, 90.5%, 53.8%, and 82.6%, respectively. Conclusion The results of this study showed that secondary ABC does not increase the risk of local recurrence after curettage in patients with GCTB of the extremities. Although rare, FFLs were present in patients with GCTB and half of those with FFLs detected on preoperative MRI had secondary ABC.

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“…There are mainly two different options to treat GCTB, namely en bloc resection of the tumor, including the adjacent joints or intralesional curettage [ 4 , 5 ]. While the latter is considered to be the standard therapy providing better functional outcomes compared to en bloc resection [ 4 ], it is, however, associated with very high recurrence rates (20–65%). The use of adjuvants such as hydrogen peroxide, ethanol, or liquid nitrogen can further influence the degree of tumor recurrence [ 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Bioactive Glass Inhibits Tumor Development from Giant Cell Tumor of Bone-Derived Neoplastic Stromal Cells in a Chicken Chorioallantoic Membrane Assay

Fellenberg

Losch

Marinescu

et al. 2023

Cancers

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Tumor recurrence is a major problem during the treatment of giant cell tumors of bone (GCTB). We recently identified tumor cell-specific cytotoxic effects of bioactive glasses (BGs) toward neoplastic stromal cells derived from GCTB tissue (GCTSCs) in vitro. Since these data indicated a promising role of BGs in the adjuvant treatment of GCTBs, we aimed to investigate the transferability of the in vitro data into the more complex in vivo situation in the current study. We first analyzed the cytotoxicity of three different BGs in vitro by WST-1 assay after co-cultivation with primary GCTSC cell lines. The effects of BGs on tumor engraftment and growth were analyzed by chicken chorioallantoic membrane (CAM) assays and subsequent quantification of tumor take rates and tumor volumes. In vitro, all tested BGs displayed a cytotoxic effect on GCTSCs that was dependent on BG composition, concentration, and particle size. Comparable effects could be observed within the in vivo environment resulting in reduced tumor take rates and tumor volumes in BG-treated samples. These data indicate a possible clinical application of BGs in the context of GCTB therapy, mediating a reduction of recurrence rates with the simultaneous promotion of bone regeneration.

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Outcome of re-operation for local recurrence following pre-operative denosumab administration and curettage for giant cell tumour of bone with difficult joint preservation

Cited by 8 publications

References 40 publications

Treatment of Recurrent Giant Cell Tumor of Bones: A Systematic Review

Treatment of Recurrent Giant Cell Tumor of Bones: A Systematic Review

Giant cell tumor of bone with secondary aneurysmal bone cyst does not have a higher risk of local recurrence

Bioactive Glass Inhibits Tumor Development from Giant Cell Tumor of Bone-Derived Neoplastic Stromal Cells in a Chicken Chorioallantoic Membrane Assay

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