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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2020

01-12-2020 | giant cell tumor | Research article

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

Authors: Xi Chen, Hairui Li, Shibai Zhu, Yiou Wang, Wenwei Qian

Published in: BMC Musculoskeletal Disorders | Issue 1/2020

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Abstract

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. Post-operative denosumab is recommended as it continuously suppress/eliminate residue tumor cells.
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Metadata
Title
Pre-operative denosumab is associated with higher risk of local recurrence in giant cell tumor of bone: a systematic review and meta-analysis
Authors
Xi Chen
Hairui Li
Shibai Zhu
Yiou Wang
Wenwei Qian
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2020
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-020-03294-2

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