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Outcome of lung metastases due to bone giant cell tumor initially managed with observation

Authors :
Shinji Tsukamoto
Giovanni Ciani
Andreas F. Mavrogenis
Cristina Ferrari
Manabu Akahane
Yasuhito Tanaka
Michele Rocca
Alessandra Longhi
Costantino Errani
Source :
Journal of Orthopaedic Surgery and Research, Vol 15, Iss 1, Pp 1-11 (2020)
Publication Year :
2020
Publisher :
BMC, 2020.

Abstract

Abstract Background The outcomes of patients with lung metastases from giant cell tumor of bone (GCTB) vary from spontaneous regression to uncontrolled growth. To investigate whether observation is an appropriate first-line management approach for patients with lung metastases from GCTB, we evaluated the outcomes of patients who were initially managed by observation. Methods We retrospectively reviewed the data of 22 patients with lung metastases from histologically confirmed GCTB who received observation as a first-line treatment approach. The median follow-up period was 116 months. Results Disease progression occurred in 12 patients (54.5%). The median interval between the discovery of lung metastases and progression was 8 months. Eight patients underwent metastasectomy following initial observation. The median interval between the discovery of lung metastases and treatment by metastasectomy was 13.5 months. None of the patients experienced spontaneous regression. Of the 22 patients, 36.4% needed a metastasectomy, and 9.1% required denosumab treatment during the course of the follow-up period. Disease progression occurred in 45.5% of the 11 patients with lung nodules ≤ 5 mm, while all five of the patients with lung nodules > 5 mm experienced disease progression. Progression-free survival was significantly worse in the group with lung nodules > 5 mm compared to the group with lung nodules ≤ 5 mm (p = 0.022). Conclusions Observation is a safe first-line method of managing patients with lung metastases from GCTB. According to radiological imaging, approximately half of the patients progressed, and approximately half required a metastasectomy or denosumab treatment. However, patients with lung nodules > 5 mm should receive careful observation because of the high rate of disease progression in this group.

Details

Language :
English
ISSN :
1749799X and 20342497
Volume :
15
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Journal of Orthopaedic Surgery and Research
Publication Type :
Academic Journal
Accession number :
edsdoj.b13bca203424975bce1a009f42edc88
Document Type :
article
Full Text :
https://doi.org/10.1186/s13018-020-02038-1