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25-10-2022 | Denosumab | Original Paper

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

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

Published in: International Orthopaedics | Issue 1/2023

Abstract

Purpose

Denosumab enables joint-sparing surgery (curettage) and surgical downstaging in patients with giant cell tumour of bone (GCTB), where joint preservation is not possible. However, denosumab treatment causes osteosclerosis of the lesion, making it difficult to curet the lesion, leaving the tumour behind, and increasing the local recurrence rate. We performed a three-centre retrospective study to investigate the postoperative local re-recurrence rate, joint preservation status, and functional outcomes of locally recurrent lesions after preoperative denosumab treatment and curettage in patients with difficult joint preservation.

Methods

We included 38 of 142 patients with primary GCTB of the extremities who underwent preoperative denosumab and curettage between 2009 and 2021 with local recurrence. Preoperative denosumab was indicated in patients with minimal residual periarticular and subchondral bones, large extraosseous lesions (Campanacci stage 3), and pathological fractures that made joint preservation difficult.

Results

Local re-recurrence occurred in 6 (15.8%) of the 38 patients. In 29 patients who underwent re-curettage, local re-recurrence occurred in six patients (20.7%); however, in nine patients who underwent en bloc resection, no local re-recurrence was observed. The joint preservation rate was 63.2% (24 of 38 patients), with a median Musculoskeletal Tumor Society score of 28 (interquartile range: 26.8–29.0). The median follow-up period after surgery for local recurrence was 63.5 months (interquartile range: 42.5–82.4).

Conclusion

Since the local re-recurrence rate after re-curettage for local recurrence was low, and the joint preservation rate and affected limb function were good, preoperative denosumab administration may be considered in patients who require downstaging to maintain good limb function (joint preservation).

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Title: Outcome of re-operation for local recurrence following pre-operative denosumab administration and curettage for giant cell tumour of bone with difficult joint preservation
Authors: Shinji Tsukamoto
Suraj Hindiskere
Kanya Honoki
Andreas F. Mavrogenis
Yasuhito Tanaka
Pramod S. Chinder
Davide Maria Donati
Costantino Errani
Publication date: 25-10-2022
Publisher: Springer Berlin Heidelberg
Keywords: Denosumab
Denosumab
Published in: International Orthopaedics / Issue 1/2023
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-022-05613-9

2024 ASCO Annual Meeting

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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