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: 2021;103-B(1):184-191.
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http://dx.doi.org/10.1302/0301-620X.103B1.BJJ-2020-0274.R1 | DOI Listing |
Ann Surg
January 2025
Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, Australia.
Objective: To explore the perspectives and experiences of patients and carers living with the long-term consequences of pelvic exenteration.
Summary Background Data: Pelvic exenteration is accepted as the standard of care for selected patients with locally advanced or recurrent rectal cancer. With contemporary 5-year survival reported at 40-60%, the number of long-term survivors is expected to increase.
Acta Chir Orthop Traumatol Cech
January 2025
University of Pisa, Department of Orthopedic and Trauma Surgery, Pisa, Italy.
Purpose Of The Study: Hand enchondromas are benign cartilage bone tumors. Curettage represents the actual gold standard for hand enchondromas. Little has been written about the effectiveness of curettage on hand functionality.
View Article and Find Full Text PDFMediastinum
November 2024
Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Thymic epithelial tumors (TETs) are rare neoplasms that include thymomas, thymic carcinomas (TCs), and thymic neuroendocrine neoplasms (TNENs). These three tumor categories differ in aggressiveness, the incidence of recurrence after resection, the pattern of recurrence, and survival outcomes. Owing to the tumor's rarity, randomized trials have not been performed in the initial treatment setting.
View Article and Find Full Text PDFPorto Biomed J
January 2025
Internal Medicine Department, Unidade Local de Saúde São João, Porto, Portugal.
Background: Increased levels of platelet distribution width (PDW) can predict cardiac death and infarction recurrence in acute myocardial infarction. PDW appears to be a prognosis marker in acute heart failure (HF); however, its impact on chronic HF is still unknown. We investigated the impact of PDW on chronic HF.
View Article and Find Full Text PDFKorean J Radiol
January 2025
Department of Radiology, Prof. Dr. Cemil Tascioglu City Hospital, University of Health Sciences, Istanbul, Türkiye.
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