Journal
EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY
Volume 32, Issue 3, Pages 567-574Publisher
SPRINGERNATURE
DOI: 10.1007/s00590-021-03012-1
Keywords
Giant cell tumor; Bone tumors; Neoplasia; Denosumab; Tumor surgery
Categories
Ask authors/readers for more resources
Neoadjuvant denosumab is equally effective in improving postoperative functional outcomes and surgical convenience, with the exception of significantly shorter intraoperative duration compared to no-denosumab group. Easier identification, resection, and lesser reconstruction are key benefits of neoadjuvant denosumab.
Background Denosumab has been approved by Food and Drug Authority in 2013 for use in surgically unresectable Giant cell tumor (GCT) to achieve resectable tumor margins. The aim of this study is to investigate the functional outcome and surgical convenience with the use of neoadjuvant denosumab before resection and reconstruction in Campanacci grade III GCT. Methods We retrospectively reviewed 70 cases of Campanacci grade III GCT receiving resection and reconstruction between January 2014 and December 2019. They were stratified into two groups: one group of 29 patients received once-weekly denosumab 120 mg for 4-weeks before resection and reconstruction, while the other group of 41 patients did not receive denosumab before resection and reconstruction. Quality of life by musculoskeletal tumor society score where 0-7 means poor, 8-14 means fair, 15-22 means good; above 22 means excellent, incidence of tumor recurrence, intraoperative duration in minutes and postoperative positive margins were assessed for each cohort after 12 months follow-up. Results There was no significant difference in musculoskeletal tumor society score (25.75 vs. 27.41; P = 0.178), incidence of recurrence (3.45% vs. 4.88%; P < 0.001), and postoperative positive margins (10.34% vs. 4.88%; P = 0.38) for both groups. However, the intraoperative duration (133.38 vs. 194.49; P < 0.001) was significantly higher in the non-denosumab group compared with denosumab group. Conclusions Neoadjuvant denosumab is equally effective considering postoperative functional outcomes and surgical convenience except intraoperative duration where it is highly helpful in saving the operating time duration. Easier identification, resection and lesser reconstruction are the key surgical convenience offered by neoadjuvant denosumab.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available