The preoperative management of patients with giant cell tumors in limb bones using denosumab therapy.

Abstract

11520 Background: Giant cell tumor (GCT) is an intermediate, locally aggressive primary bone tumor. In addition to local therapy,new drugs for the treatment of this disease have become available. The medication Denosumab, which wasoriginally used to treat osteoporosis and the solid tumor metastases to bone, eventually began to be used totreat giant cell bone tumors. In treatment of GCT, Denosumab was used as the only remedy in patients withinoperable tumors, and was also used before surgery to reduce the size of the tumor and to preserve the joint.To evaluate the effectiveness of Denosumab, while using in the preoperative period of GCT treatment. Methods: A study was conducted of 49 patients with GCT of tubular limb bones who received Denosumab beforesurgery, and 60 patients (retrospectively evaluated, without using Denosumab in our hospital from 2015 to2019). Propensity scores were compared in a 1:1 ratio between the groups receiving Denosumab and thecontrol group to minimize possible selection bias; recurrence rates, limb function, and surgical impairmentwere compared between the two groups. Results: The recurrence rate after 3 years in the Denosumab group and the control group was 12.2% and 23.3%,respectively. In the Denosumab group, 100% (n = 49) of patients underwent surgical treatment. In 44 patientstreated with Denosumab, the indices of limb joint preservation were 89.8% and 36.6% in 22 control patients.Postoperative MSTS were higher in patients in the Denosumab group than in the control group. Conclusions: Preoperative treatment with Denosumab reduced the risk of local recurrence of GCT. Preoperative treatmentwith Denosumab is indicated for patients with advanced GCT to facilitate surgical treatment and preserve thejoint. Denosumab remains a highly effective treatment for patients with GCT bone.