Clinical outcome of primary giant cell tumor of bone after curettage with or without perioperative denosumab in Japan: from a ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2018-12

AUTHORS

Hiroshi Urakawa, Tsukasa Yonemoto, Seiichi Matsumoto, Tatsuya Takagi, Kunihiro Asanuma, Munenori Watanuki, Akira Takemoto, Norifumi Naka, Yoshihiro Matsumoto, Akira Kawai, Toshiyuki Kunisada, Tadahiko Kubo, Makoto Emori, Hiroaki Hiraga, Hiroshi Hatano, Satoshi Tsukushi, Yoshihiro Nishida, Toshihiro Akisue, Takeshi Morii, Mitsuru Takahashi, Akihito Nagano, Hideki Yoshikawa, Kenji Sato, Masanori Kawano, Koji Hiraoka, Kazuhiro Tanaka, Yukihide Iwamoto, Toshifumi Ozaki

ABSTRACT

BACKGROUND: Giant cell tumor of bone (GCTB) is an intermediate tumor known to be locally aggressive, but rarely metastasizing. To plan a prospective study of GCTB, we performed a questionnaire survey for institutions participating in the Bone and Soft Tissue Tumor Study Group (BSTTSG) in the Japan Clinical Oncology Group (JCOG) in 2015. METHODS: We reviewed 158 consecutive patients with primary GCTB treated with curettage without perioperative denosumab from 2008 to 2010 in Japan. We investigated local and distant recurrence rates after definitive curettage. We also investigated the recurrence rate after treatment with preoperative and/or postoperative denosumab with curettage in recent years. There were 40 patients treated with perioperative denosumab, and the factors affecting recurrence in them were investigated. RESULTS: Answers were available from 24 of 30 institutions (80.0%) participating in JCOG BSTTSG. Thirty (19.0%) and 4 (2.5%) of 158 patients developed local and distant recurrence after curettage without perioperative denosumab from 2008 to 2010, respectively. Campanacci grade and embolization before surgery were significantly associated with increasing incidence of local recurrence after curettage (p = 0.034 and p = 0.022, respectively). In patients treated with perioperative desnosumab, 120 mg denosumab was administered subcutaneously for a median 6 (2-41) and 6 (1-14) times in preoperative and postoperative settings, respectively. The recurrence rates were 6 of 21 (28.6%), 2 of 9 (22.2%), and 0 of 10 (0.0%) in the preoperative, postoperative, and both pre- and postoperative denosumab treatment groups, respectively. With all of the preoperative treatments, administration exceeding five times was significantly associated with a decreased incidence of local recurrence after curettage (p < 0.001). CONCLUSION: The recurrence rate of GCTB was still high after curettage, especially in Campanacci grade III, and improvements in the therapeutic strategy are needed in this cohort. There is a possibility that a sufficient dose of preoperative denosumab can reduce recurrence after curettage. Recently, we have started a clinical trial, JCOG1610, to investigate the efficacy of preoperative denosumab in patients who can be treated with curettage in GCTB. More... »

PAGES

160

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12957-018-1459-6

DOI

http://dx.doi.org/10.1186/s12957-018-1459-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1106061468

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30089488


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