Development and validation of a prognostic index to predict pulmonary metastasis of giant cell tumor of bone

Wang, Bo; Chen, Wei; Xie, Xianbiao; Tu, Jian; Huang, Gang; Zou, Changye; Yin, Junqiang; Wen, Li-Li; Shen, Jingnan

doi:10.18632/oncotarget.22478

Cited by 19 publications

(11 citation statements)

References 31 publications

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“…The course of GCTB pulmonary metastasis is unpredictable. 6,7,61,64,65 Spontaneous resolution has been reported, 18,66,67 as was the case in two patients in this series. Due to the usual benign indolent course and the controversial management of such nodules, 15,17,67–70 histopathological confirmation was not obtained routinely especially with small and inaccessible nodules.…”

Section: Discussionsupporting

confidence: 66%

Giant cell tumor of bone: Unusual features of a rare tumor

et al. 2019

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Giant cell tumor of bone is a benign tumor with an aggressive behavior. Its typical subarticular location and high recurrence risk can be associated with significant morbidity. Although benign, it can rarely metastasize especially to the lungs. Also, it can be multicentric in less than 1% of patients. Late malignant transformation, although rare, can occur with a very poor prognosis. This series reports on these unusual and challenging features and management considerations of giant cell tumor of bone. This retrospective study included review of the medical records of patients with a confirmed histopathological diagnosis of giant cell tumor of bone. A total of 25 patients (16 females and 9 males) with a mean age of 34.5 years were included; 22 had primary tumors, while 3 were referred with recurrent tumors. Pain was the most common presenting symptom. Most patients had grade III tumors. Tumors around the knee were the most common. Multicentric tumors were detected in three patients. Twenty-three patients (20 primary giant cell tumor of bone and 3 with recurrence) received treatment. Most patients (15/23) were treated with intralesional curettage with or without adjuvants. Seven patients had wide excision. Recurrence was seen in 45% (9/20) of primary giant cell tumor of bone especially with difficult anatomical locations. Most recurrences occurred more than 4 years after treatment. Pulmonary nodules were detected in four patients; two of them showed resolution during follow-up. One patient developed secondary sarcoma transformation with a fatal outcome. Giant cell tumor of bone was more common in females. Long bones were more affected, especially around the knee. Intralesional curettage was the most frequently used treatment. Recurrence was associated with inadequate tumor resection (especially in difficult anatomical location), younger age, male gender, and advanced local tumor grade. Denosumab can be used in the treatment of pulmonary metastasis, multicentric and recurrent giant cell tumor of bone. Due to late recurrence and malignant transformation, a prolonged follow-up is warranted.

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Section: Discussionsupporting

confidence: 66%

Giant cell tumor of bone: Unusual features of a rare tumor

et al. 2019

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“…Lung metastases occur in 1-9% of patients with GCTBs [5][6][7][8][9]. Distal radius [8,9], Campanacci stage 3 [114], and repeated local recurrences [114][115][116][117][118][119] have been associated with lung metastases. A recent study including patients with GCTB of the extremities reported similar lung metastasis rates between the group undergoing surgery and preoperative and postoperative denosumab therapy and the group undergoing surgery alone (3.3% (1 of 30 patients) vs. 4.7% (18 of 381 patients)) [115].…”

Section: Lung Metastasismentioning

confidence: 99%

Current Concepts in the Treatment of Giant Cell Tumors of Bone

Tsukamoto

Mavrogenis

Kido

et al. 2021

Cancers

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The 2020 World Health Organization classification defined giant cell tumors of bone (GCTBs) as intermediate malignant tumors. Since the mutated H3F3A was found to be a specific marker for GCTB, it has become very useful in diagnosing GCTB. Curettage is the most common treatment for GCTBs. Preoperative administration of denosumab makes curettage difficult and increases the risk of local recurrence. Curettage is recommended to achieve good functional outcomes, even for local recurrence. For pathological fractures, joints should be preserved as much as possible and curettage should be attempted. Preoperative administration of denosumab for pelvic and spinal GCTBs reduces extraosseous lesions, hardens the tumor, and facilitates en bloc resection. Nerve-sparing surgery after embolization is a possible treatment for sacral GCTBS. Denosumab therapy with or without embolization is indicated for inoperable pelvic, spinal, and sacral GCTBs. It is recommended to first observe lung metastases, then administer denosumab for growing lesions. Radiotherapy is associated with a risk of malignant transformation and should be limited to cases where surgery is impossible and denosumab, zoledronic acid, or embolization is not available. Local recurrence after 2 years or more should be indicative of malignant transformation. This review summarizes the treatment approaches for non-malignant and malignant GCTBs.

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“…The multivariate Cox regression suggested that higher T stage was one of the prognostic factors. Tumor size as the independent risk factor for lung metastasis was previously found [18]. Based on the Campanacci classification, which has been widely accepted in evaluating giant cell tumor, grade III represented the aggressive type.…”

Section: Discussionmentioning

confidence: 97%

Survival and prognostic factors analyses in malignant giant cell tumor of bone

Zhang¹,

Wang

Li³

et al. 2019

Preprint

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Background The characteristics and survival in patients with malignant giant tumor cancer of bone (GCTB) were not investigated thoroughly due to the limited population. We evaluated the issues based on a large cohort in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database. Methods Patients who were diagnosed with malignant GCTB from 1975 to 2016 were extracted from the SEER database. The overall survival (OS) was calculated by Kaplan–Meier analysis and the inter-group difference was tested by log-rank test. Univariate and multivariate Cox proportional hazard regression were conducted to identify the independent survival factors. Results A total of 325 patients with malignant GCTB were included. The overall 1-, 5-, and 10-year survival rates were 94.3% (95% CI: 91.7-96.8), 82.3% (95% CI: 77.9-86.6), and 80.1% (95% CI: 75.4-84.7), respectively. In the univariate analysis, age older than 34 years, grade IV, T2/3 stage, M1, distant and surgery of the primary site. Multivariate Cox regression showed the poor survival in patients with age older than 34 years (hazard ratio (HR) =3.68, 95% CI: 2.06-6.57, P<0.001), T2 stage (HR=4.96, 95% CI: 1.57-15.63, P=0.006), distant tumor (HR=3.02, 95% CI: 1.32-6.92, P=0.009), and the extra-skeletal sites (HR=8.84, 95% CI: 2.89-27.07, P<0.001), respectively. Conclusions This large population-based series described the clinical characteristics of the malignant GCTB. Age, T2, distant tumor and extra-skeletal sites were determinant survival factors of the patients with malignant GCTB.

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Development and validation of a prognostic index to predict pulmonary metastasis of giant cell tumor of bone

Cited by 19 publications

References 31 publications

Giant cell tumor of bone: Unusual features of a rare tumor

Giant cell tumor of bone: Unusual features of a rare tumor

Current Concepts in the Treatment of Giant Cell Tumors of Bone

Survival and prognostic factors analyses in malignant giant cell tumor of bone

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