Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
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Igrec, J; Jernej, L; Smolle, MA; Steiner, J; Scheipl, S; Lohberger, B; Leithner, A; Brcic, I.
Surgical and radiological outcomes of giant cell tumor of the bone: prognostic value of Campanacci grading and selective use of denosumab.
J Orthop Traumatol. 2025; 26(1): 27
Doi: 10.1186/s10195-025-00841-2
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- Führende Autor*innen der Med Uni Graz
- Brcic Iva
- Igrec Jasminka
- Co-Autor*innen der Med Uni Graz
- Leithner Andreas
- Lohberger Birgit
- Scheipl Susanne
- Smolle Maria Anna
- Steiner Jakob
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- Abstract:
- BACKGROUND: Advancements in diagnostic and therapeutic modalities for giant cell tumors of bone (GCTB) have introduced molecular and radiological tools that refine clinical decision-making. H3.3 G34W immunohistochemical staining has become a routine diagnostic marker, while H3F3A mutational analysis enhances prognostic insights. Treatment primarily involves surgical methods such as curettage or en bloc resection, with denosumab serving as an adjunct in high-risk or inoperable cases. METHODS: We retrospectively analyzed 55 patients with GCTB, focusing on clinicopathologic and radiological findings. Tumors were evaluated using the Campanacci grading system. Immunohistochemical analysis with H3.3 G34W antibody and next-generation sequencing (NGS) were performed to detect H3F3A mutations. A subgroup of nine patients treated with denosumab was further analyzed for clinical outcomes and histological changes. RESULTS: The cohort had a mean age of 37.7 years, with tumors most commonly affecting the knee joint (55%). All tested tumors demonstrated positive H3.3 G34W staining, with eight exhibiting H3F3A G34W mutations. Recurrence rates were 32% following curettage and 18% after en bloc resection. Denosumab treatment, administered for an average of 14.6 months, facilitated tumor downsizing and new bone formation without major side effects. Histologically, treated tumors showed a depletion of giant cells and increased bone matrix deposition. CONCLUSIONS: Surgery remains the cornerstone of GCTB treatment, with curettage or resection tailored to tumor characteristics. Denosumab offers a valuable adjunct in high-risk cases, enhancing surgical feasibility and promoting joint preservation. The Campanacci grading system continues to be a crucial tool for prognostication and treatment planning, particularly when complemented by molecular and radiological diagnostics. Future research should focus on integrating advanced imaging and artificial intelligence for personalized GCTB management. LEVEL OF EVIDENCE: Level 4.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Denosumab - therapeutic use
- Giant Cell Tumor of Bone - diagnostic imaging, surgery, pathology, genetics, drug therapy, therapy
- Bone Neoplasms - diagnostic imaging, pathology, surgery, genetics, drug therapy, therapy
- Male - administration & dosage
- Female - administration & dosage
- Retrospective Studies - administration & dosage
- Adult - administration & dosage
- Prognosis - administration & dosage
- Middle Aged - administration & dosage
- Bone Density Conservation Agents - therapeutic use
- Neoplasm Grading - administration & dosage
- Young Adult - administration & dosage
- Curettage - administration & dosage
- Mutation - administration & dosage
- Histones - administration & dosage
- Find related publications in this database (Keywords)
- Giant cell tumor of bone
- Denosumab
- H3.3
- Radiological imaging