Factors Affecting Prognosis of Patients with Giant Cell Tumors of the Mobile Spine: Retrospective Analysis of 102 Patients in a Single Center

Xu, Wei; Li, Xiang; Huang, Wending; Wang, Yu; Han, Shuai; Chen, Su; Xu, Leqin; Yang, Xianghong; Liu, Tielong; Xiao, Jianru

doi:10.1245/s10434-012-2707-6

Cited by 79 publications

(108 citation statements)

References 38 publications

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“…Xu et al . demonstrate that the removal of the entire osseous compartment either using en bloc or piecemeal methods is acceptable if combined with the long‐term use of bisphosphonates6. The excision of the lesion should be done carefully and thoroughly, without missing any corners, which is the key to preventing recurrence.…”

Section: Discussionmentioning

confidence: 99%

“…RT can reduce the recurrence rate after surgery, and, furthermore, it can be used for SGCT patients not suitable for surgery20, 21, 22. Advances in RT technology may improve its effectiveness; however, high‐level evidence for the effectiveness of these therapies is lacking, and some authors have even found that RT does not improve recurrence rates6, 23. The risks of radiation‐induced spinal cord myelitis and malignant transformation cannot be ignored3.…”

Section: Discussionmentioning

confidence: 99%

“…Although SAE can reduce the recurrence rate of SGCT, high‐level evidence for the effectiveness of this method is lacking6, 24. Serial SAE as a stand‐alone treatment for SGCT is not a highly effective approach; it is usually used in inoperable SGCT24.…”

Section: Discussionmentioning

confidence: 99%

“…The cases of SGCT reported are relatively rare, and most information comes from small case series6, 7, 8, 9, 10. Although spinal GCT have a high recurrence rate of approximately 25%–50%, surgical resection is the mainstay of management3, 11.…”

Section: Introductionmentioning

confidence: 99%

“…The management of spinal GCT is challenging, due to their adjacent critical structures, such as the spinal cord, the aorta, the vena cava, the vertebral artery, and the nerve root12. Radical excision of SGCT results in a lower recurrence rate and better prognosis compared with intralesional excision but is extremely difficult is and sometimes associated with considerable functional morbidity and other complications6, 12, 13, 14. Because complete resection of these lesions remains a challenging surgical problem, many surgeons use curettage as a primary method of treatment.…”

Section: Introductionmentioning

confidence: 99%

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Recurrence of Giant Cell Tumor of the Spine after Resection: A Report of 10 Cases

Lin

Teng

et al. 2018

Orthopaedic Surgery

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ObjectiveTo review the clinical details and further treatments for recurrent spinal giant cell tumors (SGCT), and to analyze the risk factors of recurrence and shed new light on the treatment options and prognosis of recurrent SGCT.MethodsA retrospective analysis of recurrent SGCT between April 2003 and January 2014 was performed. A total of 10 patients comprising 3 men and 7 women with a mean age of 28.9 years (range, 21–40 years) were included in the study. All complete clinical data, radiographs, CT, MRI, scans and pathological data were reviewed. The tumor locations and the regions involved were evaluated by CT and MRI. The blood supply of the tumors was evaluated by enhanced CT and MRI. The mean follow‐up was 81.3 months (range, 35.7–172.1 months).ResultsAll patients had Enneking stage 3 tumors; 9 (90%) of them had different extents of spinal canal involvement in the primary time period. All patients underwent intralesional resection during their first surgery. Only 1 patient received local adjuvant treatments; no patient underwent selective arterial embolization or used denosumab at that time. Only 1 patient underwent adjuvant radiotherapy postoperatively, and another patient used bisphosphonates. After recurrence, 1 patient was cured using denosumab, and 2 patients' disease was controlled through use of other medical treatments or adjuvant treatments. There were 3 repeated recurrences and 7 repeated surgical procedures were performed in 5 patients. There were 6 intralesional excisions and 1 decompression surgery. The mean relapse‐free time after the first surgery was 32.3 months (range, 10.5–62.6 months). The overall mean relapse‐free time was 40.2 months (range, 10.5–157 months). No distant metastasis was found in our series. At the final follow‐up, 4 patients were disease free, 3 patients' disease was under control, 2 has progressive disease aggravation, while 1 patient died as a result of progression of disease 133.9 months after first surgery.ConclusionIntralesional excision for recurrent spinal giant cell tumors is an effective option that may have satisfactory prognosis. However, the excision and the inactivation of the lesion should be carried out carefully and thoroughly without missing any corners. Early diagnosis of recurrence may be associated with better prognosis. Adjuvant treatments perioperatively and systemic medical treatments can decrease recurrence rates and can have therapeutic effects in the recurrent SGCT.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Recurrence of Giant Cell Tumor of the Spine after Resection: A Report of 10 Cases

Lin

Teng

et al. 2018

Orthopaedic Surgery

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TGF‐β induced PAR‐1 expression promotes tumor progression and osteoclast differentiation in giant cell tumor of bone

Wang

Jiao

Zhang

et al. 2017

Intl Journal of Cancer

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Although protease activated receptor-1 (PAR-1) has been confirmed as an oncogene in many cancers, the role of PAR-1 in giant cell tumor (GCT) of bone has been rarely reported. The mechanism of PAR-1 in tumor-induced osteoclastogenesis still remains unclear. In the present study, we detected that PAR-1 was significantly upregulated in GCT of bone compared to normal tissues, while TGF-β was also overexpressed in GCT tissues and could promote the expression of PAR-1 in a dose and time dependent manner. Using the luciferase reporter assay, we found that two downstreams of TGF-β, Smad3 and Smad4, could activate the promoter of PAR-1, which might explain the mechanism of TGF-β induced PAR-1 expression. Meanwhile, PAR-1 was also overexpressed in microvesicles from stromal cells of GCT (GCTSCs), and might be transported from GCTSCs to monocytes through microvesicles. In addition, knockout of PAR-1 by TALENs in GCTSCs inhibited tumor growth, angiogenesis and osteoclastogenesis in GCT in vitro. Using the chick CAM models, we further showed that inhibition of PAR-1 suppressed tumor growth and giant cell formation in vivo. Using microarray assay, we detected a number of genes involved in osteoclastogenesis as the possible downstreams of PAR-1, which may partly explain the mechanism of PAR-1 in GCT. In brief, for the first time, these results reveal an upstream regulatory role of TGF-β in PAR-1 expression, and PAR-1 expression promotes tumor growth, angiogenesis and osteoclast differentiation in GCT of bone. Hence, PAR-1 represents a novel potential therapeutic target for GCT of bone.

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Giant Cell Tumor of the Spine

Orguc,

Açar,

Arkun

2023

Medical Radiology

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Factors Affecting Prognosis of Patients with Giant Cell Tumors of the Mobile Spine: Retrospective Analysis of 102 Patients in a Single Center

Cited by 79 publications

References 38 publications

Recurrence of Giant Cell Tumor of the Spine after Resection: A Report of 10 Cases

Recurrence of Giant Cell Tumor of the Spine after Resection: A Report of 10 Cases

TGF‐β induced PAR‐1 expression promotes tumor progression and osteoclast differentiation in giant cell tumor of bone

Giant Cell Tumor of the Spine

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