Outcome of lung metastases due to bone giant cell tumor initially managed with observation.
Adult
Bone Density Conservation Agents
/ administration & dosage
Bone Neoplasms
/ pathology
Combined Modality Therapy
Conservative Treatment
/ methods
Denosumab
/ administration & dosage
Disease Progression
Disease-Free Survival
Female
Follow-Up Studies
Giant Cell Tumor of Bone
/ pathology
Humans
Lung Neoplasms
/ mortality
Male
Middle Aged
Pneumonectomy
/ methods
Retrospective Studies
Time Factors
Treatment Outcome
Denosumab
Giant cell tumor of bone
Lungs
Metastasectomy
Metastasis
Observation
Journal
Journal of orthopaedic surgery and research
ISSN: 1749-799X
Titre abrégé: J Orthop Surg Res
Pays: England
ID NLM: 101265112
Informations de publication
Date de publication:
07 Nov 2020
07 Nov 2020
Historique:
received:
17
07
2020
accepted:
28
10
2020
entrez:
8
11
2020
pubmed:
9
11
2020
medline:
3
6
2021
Statut:
epublish
Résumé
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. 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. 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). 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.
Sections du résumé
BACKGROUND
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
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
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
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.
Identifiants
pubmed: 33160367
doi: 10.1186/s13018-020-02038-1
pii: 10.1186/s13018-020-02038-1
pmc: PMC7648999
doi:
Substances chimiques
Bone Density Conservation Agents
0
Denosumab
4EQZ6YO2HI
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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