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Role of denosumab before resection and reconstruction in giant cell tumors of bone: a single-centered retrospective cohort study

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

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Abstract

Background

Denosumab has been approved by Food and Drug Authority in 2013 for use in surgically unresectable Giant cell tumor (GCT) to achieve resectable tumor margins. The aim of this study is to investigate the functional outcome and surgical convenience with the use of neoadjuvant denosumab before resection and reconstruction in Campanacci grade III GCT.

Methods

We retrospectively reviewed 70 cases of Campanacci grade III GCT receiving resection and reconstruction between January 2014 and December 2019. They were stratified into two groups: one group of 29 patients received once-weekly denosumab 120 mg for 4-weeks before resection and reconstruction, while the other group of 41 patients did not receive denosumab before resection and reconstruction. Quality of life by musculoskeletal tumor society score where 0–7 means poor, 8–14 means fair, 15–22 means good; above 22 means excellent, incidence of tumor recurrence, intraoperative duration in minutes and postoperative positive margins were assessed for each cohort after 12 months follow-up.

Results

There was no significant difference in musculoskeletal tumor society score (25.75 vs. 27.41; P  = 0.178), incidence of recurrence (3.45% vs. 4.88%; P  < 0.001), and postoperative positive margins (10.34% vs. 4.88%; P  = 0.38) for both groups. However, the intraoperative duration (133.38 vs. 194.49; P  < 0.001) was significantly higher in the non-denosumab group compared with denosumab group.

Conclusions

Neoadjuvant denosumab is equally effective considering postoperative functional outcomes and surgical convenience except intraoperative duration where it is highly helpful in saving the operating time duration. Easier identification, resection and lesser reconstruction are the key surgical convenience offered by neoadjuvant denosumab.

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Data availability

All data were obtained from Orthopedic Surgery Department of Dr Ruth KM Pfau Civil Hospital Karachi, Pakistan.

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Acknowledgements

We would like to acknowledge the resident doctors/trainees and nurses of our department who have worked with utmost sincerity for maintaining the records of these patients.

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Authors and Affiliations

  1. Department of Orthopaedics, Dr Ruth KM Pfau Civil Hospital Karachi/Dow University of Health Sciences, Karachi, Pakistan

    Badaruddin Sahito, Dileep Kumar, Jagdesh Kumar, Nauman Hussain & Tahir Lakho

  2. Department of Orthopaedics Unit II, Dr Ruth KM Pfau Civil Hospital Karachi, Baba e Urdu Road, Saddar, Karachi, Pakistan

    Sheikh Muhammad Ebad Ali

Authors
  1. Badaruddin Sahito
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  2. Sheikh Muhammad Ebad Ali
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  3. Dileep Kumar
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  4. Jagdesh Kumar
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  5. Nauman Hussain
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  6. Tahir Lakho
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Contributions

Dr. BS and Dr. DK performed conception, data collection and critical revision while Dr. SMEA, Dr. NH, and Dr. TL performed designing, data interpretation and drafting. All the authors approved the final draft and stand accountable for validity of data.

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Correspondence to Sheikh Muhammad Ebad Ali.

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All patients were called and written consents were taken.

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IRB was obtained from the institution.

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Sahito, B., Ali, S.M.E., Kumar, D. et al. Role of denosumab before resection and reconstruction in giant cell tumors of bone: a single-centered retrospective cohort study. Eur J Orthop Surg Traumatol 32, 567–574 (2022). https://doi.org/10.1007/s00590-021-03012-1

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  • DOI: https://doi.org/10.1007/s00590-021-03012-1

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