The Effect of Denosumab and Risk Factors for Recurrence in Spinal Giant Cell Tumors: A Systematic Review and Meta-Analysis
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Purpose: Giant cell tumors (GCTs) are common benign primary bone tumors and are well known for their locally aggressive per-formance and tendency to recur. The purpose of this study was to analyze the effects of denosumab and risk factors for recurrentspinal GCTs. Materials and Methods: We searched PubMed, EMBASE, Web of Science, and Cochrane Library databases to identify differencesbetween individuals treated with and without denosumab and risk factors for spinal GCT recurrence. Patient data, including age,sex, tumor resection range, location, denosumab use, Campanacci grade, and radiotherapy, were documented. Comparable fac-tors were evaluated using odds ratios (ORs) and weighted mean differences (WMDs) with 95% confidence intervals (CIs). Results: Sixteen studies were included. The overall incidence of spinal GCT recurrence was 29%. Campanacci grade III tumorsshowed better recurrence outcomes than grades I and II (OR, 16.36; 95% CI, 4.19–63.93; p<0.001). Gross total resection (OR, 0.09;95% CI, 0.04–0.19; p<0.001), radiotherapy (OR, 0.27; 95% CI, 0.11–0.65; p=0.004), and the use of denosumab during subtotal resec-tion (OR, 2.95; 95% CI, 1.07–8.17; p=0.04) were important factors for reducing recurrence. Conclusion: Clinicians must consider the effects of gross total resection, radiotherapy use, and denosumab use in cases of subto-tal resection during spinal GCT treatment. So far, many researchers have used denosumab in spinal GCT, but none have clearlysuggested an endpoint. Most studies, however, recommend using it for more than 6 months.
Abstract
Purpose: Giant cell tumors (GCTs) are common benign primary bone tumors and are well known for their locally aggressive per-formance and tendency to recur. The purpose of this study was to analyze the effects of denosumab and risk factors for recurrentspinal GCTs. Materials and Methods: We searched PubMed, EMBASE, Web of Science, and Cochrane Library databases to identify differencesbetween individuals treated with and without denosumab and risk factors for spinal GCT recurrence. Patient data, including age,sex, tumor resection range, location, denosumab use, Campanacci grade, and radiotherapy, were documented. Comparable fac-tors were evaluated using odds ratios (ORs) and weighted mean differences (WMDs) with 95% confidence intervals (CIs). Results: Sixteen studies were included. The overall incidence of spinal GCT recurrence was 29%. Campanacci grade III tumorsshowed better recurrence outcomes than grades I and II (OR, 16.36; 95% CI, 4.19–63.93; p<0.001). Gross total resection (OR, 0.09;95% CI, 0.04–0.19; p<0.001), radiotherapy (OR, 0.27; 95% CI, 0.11–0.65; p=0.004), and the use of denosumab during subtotal resec-tion (OR, 2.95; 95% CI, 1.07–8.17; p=0.04) were important factors for reducing recurrence. Conclusion: Clinicians must consider the effects of gross total resection, radiotherapy use, and denosumab use in cases of subto-tal resection during spinal GCT treatment. So far, many researchers have used denosumab in spinal GCT, but none have clearlysuggested an endpoint. Most studies, however, recommend using it for more than 6 months.
참고문헌 (32)
- Sung HW, "Giant-cell tumor of bone : analysis of two hundred and eight cases in Chinese patients", J Bone Joint Surg Am, 64, pp.755~761 (1982)
- Fletcher C, "WHO classification of tumours of soft tissue and bone: WHO classification of tumours, vol. 5" (2013), International Agency for Research on Cancer
- Dahlin DC, "Giant-cell tumor: a study of 195 cases", Cancer, 25, pp.1061~1070 (1970)
- Siebenrock KA, "Giant-cell tumour of bone metastasising to the lungs. A long-term follow-up", J Bone Joint Surg Br, 80, pp.43~47 (1998)
- Goldenberg RR, "Giant-cell tumor of bone. An analysis of two hundred and eighteen cases", J Bone Joint Surg Am, 52, pp.619~664 (1970)
- Boriani S, "Giant cell tumor of the mobile spine : a review of 49cases", Spine(Phila Pa 1976), 37, pp.E37~45 (2012)
- Charest-Morin R, "En bloc resection versus intralesional surgery in the treatment of giant cell tumor of the spine", Spine(Phila Pa 1976), 42, pp.1383~1390 (2017)
- Xu W, "Factors affecting prognosis of patients with giant cell tumors of the mobile spine : retrospective analysis of 102 patients in a single center", Ann Surg Oncol, 20, pp.804~810 (2012)
- Zhou H, "Surgical approach selection for total spondylectomy for the treatment of giant cell tumors in the lumbar spine : a retrospective analysis of 12patients from a single center", Asia Pac J Clin Oncol, 14, pp.e103~e108 (2018)
- Boriani S, "Denosumab in the treatment of giant cell tumor of the spine. Preliminary report, review of the literature and protocol proposal", Eur Spine J, 29, pp.257~271 (2020)
- Chawla S, "Safety and efficacy of denosumab for adults and skeletally mature adolescents with giant cell tumour of bone : interim analysis of an open-label, parallel-group, phase 2 study", Lancet Oncol, 14, pp.901~908 (2013)
- Shamseer L, "Preferred reporting items for systematic review and metaanalysis protocols(PRISMA-P)2015 : elaboration and explanation", BMJ, 349, pp.g7647~ (2015)
- Luksanapruksa P, "Systematic review and meta-analysis of en bloc vertebrectomy compared with intralesional resection for giant cell tumors of the mobile spine", Global Spine J, 6, pp.798~803 (2016)
- Jia Q, "Clinical features and prognostic factors of pediatric spine giant cell tumors : report of 31 clinical cases in a single center", Spine J, 19, pp.1232~1241 (2019)
- O’Donnell RJ, "Recurrence of giant-cell tumors of the long bones after curettage and packing with cement", J Bone Joint Surg Am, 76, pp.1827~1833 (1994)
- Jamshidi K, "Giant cell tumor of the sacrum : series of 19 patients and review of the literature", Arch Bone Jt Surg, 5, pp.443~450 (2017)
- Wang J, "Analysis of clinical outcome for adolescent patients undergoing conservative nervesparing surgery based on the proposed resection classification for sacral giant cell tumor", J Clin Neurosci, 80, pp.23~29 (2020)
- Goldschlager T, "Giant cell tumors of the spine : has denosumab changed the treatment paradigm?", J Neurosurg Spine, 22, pp.526~533 (2015)
- Sambri A, "Denosumab in giant cell tumour of bone in the pelvis and sacrum : long-term therapy or bone resection?", J Orthop Sci, 25, pp.513~519 (2020)
- Yang Y, "A nonrandomized controlled study of sacral giant cell tumors with preoperative treatment of denosumab", Medicine(Baltimore), 97, pp.e13139~ (2018)
- Chen X, "Pre-operative denosumab is associated with higher risk of local recurrence in giant cell tumor of bone : a systematic review and meta-analysis", BMC Musculoskelet Disord, 21, pp.256~ (2020)
- Chen Z, "Therapeutic benefits of neoadjuvant and post-operative denosumab on sacral giant cell tumor : a retrospective cohort study of 30 cases", J BUON, 23, pp.453~459 (2018)
- Lim CY, "Retrospective cohort study of 68 sacral giant cell tumours treated with nerve-sparing surgery and evaluation on therapeutic benefits of denosumab therapy", Bone Joint J, 102-B, pp.177~185 (2020)
- Müther M, "Multiprofessional management of giant cell tumors in the cervical spine : a systematic review", World Neurosurg, 151, pp.53~60 (2021)
- Martin C, "Giant cell tumor of the sacrum and spine : series of 23 cases and a review of the literature", Iowa Orthop J, 30, pp.69~75 (2010)
- Junming M, "Giant cell tumor of the cervical spine: a series of 22 cases and outcomes", Spine (Phila Pa 1976), 33, pp.280~288 (2008)
- Ouyang HQ, "Recurrence factors in giant cell tumors of the spine", Chin Med J(Engl), 130, pp.1557~1563 (2017)
- Yokogawa N, "Total spondylectomy for Enneking stage III giant cell tumor of the mobile spine", Eur Spine J, 27, pp.3084~3091 (2018)
- Caudell JJ, "Radiotherapy in the management of giant cell tumor of bone", Int J Radiat Oncol Biol Phys, 57, pp.158~165 (2003)
- Domovitov SV, "Conservative surgery in the treatment of giant cell tumor of the sacrum : 35 years’ experience", J Neurosurg Spine, 24, pp.228~240 (2016)
- Seon Chun Kim, "Clinical Outcome of Treatment for Patients with Giant Cell Tumor in Spine", 대한신경외과학회지, 58(3), pp.248~253 (2015), 대한신경외과학회
- Tsukamoto S, "Intralesional nerve-sparing surgery versus non-surgical treatment for giant cell tumor of the sacrum", BMC Musculoskelet Disord, 22, pp.1023~ (2021)