Open AccessIs Treatment with Denosumab Associated with Local Recurrence in Patients with Giant Cell Tumor of Bone Treated with Curettage? A Systematic Review
Author(s) -
Shinji Tsukamoto,
Yuu Tanaka,
Andreas F. Mavrogenis,
Akira Kido,
Masahiko Kawaguchi,
Costantino Errani
Publication year - 2019
Publication title -
clinical orthopaedics and related research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.178
H-Index - 204
eISSN - 1528-1132
pISSN - 0009-921X
DOI - 10.1097/corr.0000000000001074
Subject(s) - denosumab , medicine , curettage , giant cell tumor of bone , surgery , randomized controlled trial , giant cell , oncology , osteoporosis , pathology
Denosumab, a monoclonal antibody that binds to receptor activation of nuclear factor-kappa ß ligand (RANKL), has been used as a drug to treat aggressive giant cell tumors of bone. It is unclear whether preoperative denosumab therapy is associated with the local recurrence risk in patients with giant cell tumors of bone treated with curettage. Early evidence suggests that denosumab treatment is associated with a reduction in local recurrence, but other studies have questioned that premise. Curettage after a short course of denosumab (3 to 4 months) has been recommended, especially for large, aggressive giant cell tumors in which complete curettage is difficult to achieve. No randomized studies have documented the benefit of this approach, and some investigators have reported higher local recurrence after denosumab treatment. Due to this confusion, we performed a systematic analysis of existing reports to attempt to answer this question and determine whether the appropriate preoperative denosumab therapy duration could be established.