Shinji Tsukamoto1, Andreas F Mavrogenis2, Giulio Leone3, Alberto Righi4, Manabu Akahane5, Piergiuseppe Tanzi6, Akira Kido7, Kanya Honoki7, Yasuhito Tanaka7, Davide Maria Donati6, Costantino Errani8. 1. Department of Orthopaedics, Nara Medical University, Nara, Japan. shinji104@mail.goo.ne.jp. 2. First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, 41 Ventouri Str., 15562, Athens, Greece. afm@otenet.gr. 3. Department of Orthopaedics, San Gerardo Hospital, Monza, Italy. 4. Department of Pathology, Istituto Ortopedico Rizzoli, Bologna, Italy. 5. Department of Public Health, Health Management, and Policy, Nara Medical University, Nara, Japan. 6. Department of Orthopaedic Oncology, Istituto Ortopedico Rizzoli, Bologna, Italy. 7. Department of Orthopaedics, Nara Medical University, Nara, Japan. 8. Department of Orthopaedic Oncology, Istituto Ortopedico Rizzoli, Bologna, Italy. costantino.errani@ior.it.
Abstract
PURPOSE: There are conflicting reports on the effect of denosumab on lung metastases in patients with giant cell tumor (GCT) of bone. To address these reports, we performed this study to determine if denosumab prevents lung metastasis and to evaluate univariate and multivariate predictors for lung metastases in these patients. MATERIALS AND METHODS: We retrospectively studied 381 GCT patients with surgery alone and 30 GCT patients with surgery and denosumab administration. The median follow-up was 85.2 months (IQR, 54.2-124.4 months). We evaluated lung metastases and local recurrences, univariate and multivariate predictors for lung metastases, response, and adverse events of denosumab administration. RESULTS: The occurrence of lung metastases was similar (surgery alone 4.7%, 18 patients; denosumab administration 3.3%, 1 patient); however, the occurrence of local recurrences was significantly higher in the patients with denosumab administration. Denosumab administration was not an important predictor for lung metastases; Campanacci stage and type of surgery were the only univariate predictors for lung metastases, and type of surgery and local recurrence were the only multivariate predictors for lung metastases. Histology showed viable tumour in all tumor specimens of the patients with denosumab administration. CONCLUSION: Denosumab does not decrease the risk of lung metastases in patients with bone GCT; the only important predictors for lung metastases in these patients are type of surgery and local recurrence. However, because the number of patients with lung metastases was small for a multivariate analysis, the possibility of denosumab's effect could not be completely eliminated.
PURPOSE: There are conflicting reports on the effect of denosumab on lung metastases in patients with giant cell tumor (GCT) of bone. To address these reports, we performed this study to determine if denosumab prevents lung metastasis and to evaluate univariate and multivariate predictors for lung metastases in these patients. MATERIALS AND METHODS: We retrospectively studied 381 GCT patients with surgery alone and 30 GCT patients with surgery and denosumab administration. The median follow-up was 85.2 months (IQR, 54.2-124.4 months). We evaluated lung metastases and local recurrences, univariate and multivariate predictors for lung metastases, response, and adverse events of denosumab administration. RESULTS: The occurrence of lung metastases was similar (surgery alone 4.7%, 18 patients; denosumab administration 3.3%, 1 patient); however, the occurrence of local recurrences was significantly higher in the patients with denosumab administration. Denosumab administration was not an important predictor for lung metastases; Campanacci stage and type of surgery were the only univariate predictors for lung metastases, and type of surgery and local recurrence were the only multivariate predictors for lung metastases. Histology showed viable tumour in all tumor specimens of the patients with denosumab administration. CONCLUSION:Denosumab does not decrease the risk of lung metastases in patients with bone GCT; the only important predictors for lung metastases in these patients are type of surgery and local recurrence. However, because the number of patients with lung metastases was small for a multivariate analysis, the possibility of denosumab's effect could not be completely eliminated.
Entities:
Keywords:
Denosumab; Giant cell tumour of bone; Lungs; Metastasis
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