Systemic Therapy in Patients with Resectable and Unresectable Cases of Giant Cell Tumor: A Systematic Review
Abstract
Background: Giant cell
tumor (GCT) is a common benign tumor of the appendicular and axial skeleton
that represents 5% of all primary bone tumors. In recent years, the combination
of conventional aggressive curettage with targeted adjuvant anti-osteoclastic
agents including bisphosphonates and denosumab have led to lower recurrence
rates in patients with GCT in a small number of retrospective case series.
Furthermore, efficacy of the same anti-osteoclastic agents has been shown in
cases of unresectable GCT of bone, leading to decreased rates of tumor
progression and stabilization of disease. This review assesses whether the
current literature weakly, moderately, or strongly supports a targeted systemic
treatment as the standard of care in patients with GCT. Methods: We conducted a
current search of the MEDLINE database for literature pertaining to systemic
GCT treatment. Our inclusion criteria were as follows: 1) studies that reported
on a series of patients with resectable or unresectable cases of GCT; 2) a subset of patients must have been
treated with systemic bisphosphonate or RANK-L inhibitor therapy; 3) each series had a minimum of 10
patients with histopathologically confirmed GCT; 4) each series stated their follow-up
period. Results: Overall 6 studies, reporting on a total of 487 patients, were
selected for inclusion in this review. For analysis, these 6 retrospective
studies were subdivided into series where all GCT patients had resectable
tumors (n = 4) and series…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 487 participants or records.
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