Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel

The role of Denosumab in joint preservation for patients with giant cell tumour of bone.

Publication ,  Journal Article
Perrin, DL; Visgauss, JD; Wilson, DA; Griffin, AM; Abdul Razak, AR; Ferguson, PC; Wunder, JS
Published in: Bone Joint J
January 2021

AIMS: Local recurrence remains a challenging and common problem following curettage and joint-sparing surgery for giant cell tumour of bone (GCTB). We previously reported a 15% local recurrence rate at a median follow-up of 30 months in 20 patients with high-risk GCTB treated with neoadjuvant Denosumab. The aim of this study was to determine if this initial favourable outcome following the use of Denosumab was maintained with longer follow-up. METHODS: Patients with GCTB of the limb considered high-risk for unsuccessful joint salvage, due to minimal periarticular and subchondral bone, large soft tissue mass, or pathological fracture, were treated with Denosumab followed by extended intralesional curettage with the goal of preserving the joint surface. Patients were followed for local recurrence, metastasis, and secondary sarcoma. RESULTS: A total of 25 patients with a mean age of 33.8 years (18 to 67) with high-risk GCTB received median six cycles of Denosumab before surgery. Tumours occurred most commonly around the knee (17/25, 68%). The median follow-up was 57 months (interquartile range (IQR) 13 to 88). The joint was salvaged in 23 patients (92%). Two required knee arthroplasty due to intra-articular fracture and arthritis. Local recurrence developed in 11 patients (44%) at a mean of 32.5 months (3 to 75) following surgery, of whom four underwent repeat curettage and joint salvage. One patient developed secondary osteosarcoma and another benign GCT lung metastases. CONCLUSION: The use of Denosumab for joint salvage was associated with a higher than expected rate of local recurrence at 44%. Neoadjuvant Denosumab for joint-sparing procedures should be considered with caution in light of these results. Cite this article: Bone Joint J 2021;103-B(1):184-191.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Bone Joint J

DOI

EISSN

2049-4408

Publication Date

January 2021

Volume

103-B

Issue

1

Start / End Page

184 / 191

Location

England

Related Subject Headings

  • Salvage Therapy
  • Prospective Studies
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male
  • Humans
  • Giant Cell Tumor of Bone
  • Fracture Fixation, Internal
  • Follow-Up Studies
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Perrin, D. L., Visgauss, J. D., Wilson, D. A., Griffin, A. M., Abdul Razak, A. R., Ferguson, P. C., & Wunder, J. S. (2021). The role of Denosumab in joint preservation for patients with giant cell tumour of bone. Bone Joint J, 103-B(1), 184–191. https://doi.org/10.1302/0301-620X.103B1.BJJ-2020-0274.R1
Perrin, David Louis, Julia D. Visgauss, David A. Wilson, Anthony M. Griffin, Albiruni R. Abdul Razak, Peter C. Ferguson, and Jay S. Wunder. “The role of Denosumab in joint preservation for patients with giant cell tumour of bone.Bone Joint J 103-B, no. 1 (January 2021): 184–91. https://doi.org/10.1302/0301-620X.103B1.BJJ-2020-0274.R1.
Perrin DL, Visgauss JD, Wilson DA, Griffin AM, Abdul Razak AR, Ferguson PC, et al. The role of Denosumab in joint preservation for patients with giant cell tumour of bone. Bone Joint J. 2021 Jan;103-B(1):184–91.
Perrin, David Louis, et al. “The role of Denosumab in joint preservation for patients with giant cell tumour of bone.Bone Joint J, vol. 103-B, no. 1, Jan. 2021, pp. 184–91. Pubmed, doi:10.1302/0301-620X.103B1.BJJ-2020-0274.R1.
Perrin DL, Visgauss JD, Wilson DA, Griffin AM, Abdul Razak AR, Ferguson PC, Wunder JS. The role of Denosumab in joint preservation for patients with giant cell tumour of bone. Bone Joint J. 2021 Jan;103-B(1):184–191.

Published In

Bone Joint J

DOI

EISSN

2049-4408

Publication Date

January 2021

Volume

103-B

Issue

1

Start / End Page

184 / 191

Location

England

Related Subject Headings

  • Salvage Therapy
  • Prospective Studies
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male
  • Humans
  • Giant Cell Tumor of Bone
  • Fracture Fixation, Internal
  • Follow-Up Studies
  • Female