Comprehensive treatment outcomes of giant cell tumor of the spine: A retrospective study

Abstract

There is no consensus on a treatment strategy for spinal giant cell tumor of bone (GCTB) because of the difficulty in their treatment. Treatment options often include the use of the controversial denosumab, an antibody therapy aimed at tumor shrinkage, different curettage techniques, resection, or a combination of these therapies. The current study aimed to identify treatment methods associated with favorable outcomes in patients with spinal GCTB. We retrospectively reviewed 5 patients with spinal GCTB, including patients with tumors of the sacrum, treated at our hospital between September 2011 and November 2020. Two men and 3 women were included in the study. The median follow-up period was 74 months (range: 14–108 months). We surveyed the tumor site, treatment method, denosumab use, and outcomes. The median age was 17 years (range: 17–42 years). There were 2 cases of sacral GCTB and 1 case each of lumbar, cervical, and thoracic vertebral GCTB. The comorbidities observed included hepatitis, malignant lymphoma, atopic dermatitis, and asthma. The treatment method included zoledronic acid after embolization and denosumab, denosumab only, curettage and posterior fusion, and curettage resection after embolization and anterior and posterior fusion. Denosumab was used in all cases. Three patients were continuously disease-free, 1 patient with no evidence of disease, and 1 patient alive with disease. Aggressive treatment, especially surgical treatment, may lead to good results in spinal GCTB.

Percutaneous Superimposed O-Arm-MRI-Navigated Biopsy for Spinal Column Pathologies

“…It is worth emphasizing that the histopathological assessment of giant cell tumor of bone (GCTB) following denosumab treatment should be approached cautiously due to the possibility of alterations in cell count and the emergence of new bone [ 24 , 25 , 26 ]. Nevertheless, certain studies have reported no substantial pathological changes upon histopathological analysis following denosumab treatment [ 27 ].…”

Complications and Risk Factors in En Bloc Resection of Spinal Tumors: A Retrospective Analysis on 298 Patients Treated in a Single Institution

“…Within a multidisciplinary management of spinal tumors, it is important to enhance integration between surgery and other treatments, focusing on timing and proper planning, to reduce the risks and maximize the efficacy of each treatment. Adjuvant therapies, such as chemotherapy for osteosarcoma and Ewing’s sarcoma or Denosumab for giant cell tumor [ 32 ], can facilitate en bloc resection, by reducing the tumor volume and inducing ossification, which makes the lesion margins more identifiable.…”