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Denosumab does not decrease the risk of lung metastases from bone giant cell tumour

  • Shinji Tsukamoto
  • Andreas F. Mavrogenis
  • Giulio Leone
  • Alberto Righi
  • Manabu Akahane
  • Piergiuseppe Tanzi
  • Akira Kido
  • Kanya Honoki
  • Yasuhito Tanaka
  • Davide Maria Donati
  • Costantino Errani
Original Paper
  • 125 Downloads

Abstract

Purpose

There are conflicting reports on the effect of denosumab on lung metastases in patients with giant cell tumor (GCT) of bone. To address these reports, we performed this study to determine if denosumab prevents lung metastasis and to evaluate univariate and multivariate predictors for lung metastases in these patients.

Materials and methods

We retrospectively studied 381 GCT patients with surgery alone and 30 GCT patients with surgery and denosumab administration. The median follow-up was 85.2 months (IQR, 54.2–124.4 months). We evaluated lung metastases and local recurrences, univariate and multivariate predictors for lung metastases, response, and adverse events of denosumab administration.

Results

The occurrence of lung metastases was similar (surgery alone 4.7%, 18 patients; denosumab administration 3.3%, 1 patient); however, the occurrence of local recurrences was significantly higher in the patients with denosumab administration. Denosumab administration was not an important predictor for lung metastases; Campanacci stage and type of surgery were the only univariate predictors for lung metastases, and type of surgery and local recurrence were the only multivariate predictors for lung metastases. Histology showed viable tumour in all tumor specimens of the patients with denosumab administration.

Conclusion

Denosumab does not decrease the risk of lung metastases in patients with bone GCT; the only important predictors for lung metastases in these patients are type of surgery and local recurrence. However, because the number of patients with lung metastases was small for a multivariate analysis, the possibility of denosumab’s effect could not be completely eliminated.

Keywords

Giant cell tumour of bone Denosumab Metastasis Lungs 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the independent ethics committee of senior author’s institution and is registered with ClinicalTrials.gov (identifier NCT02996734).

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© SICOT aisbl 2018
corrected publication September/2018

Authors and Affiliations

  1. 1.Department of OrthopaedicsNara Medical UniversityNaraJapan
  2. 2.First Department of OrthopaedicsNational and Kapodistrian University of Athens, School of MedicineAthensGreece
  3. 3.Department of OrthopaedicsSan Gerardo HospitalMonzaItaly
  4. 4.Department of PathologyIstituto Ortopedico RizzoliBolognaItaly
  5. 5.Department of Public Health, Health Management, and PolicyNara Medical UniversityNaraJapan
  6. 6.Department of Orthopaedic OncologyIstituto Ortopedico RizzoliBolognaItaly

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