Skip to main content

Advertisement

SpringerLink
Log in

Pulmonary metastasis of giant cell tumour: a retrospective study of three hundred and ten cases

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Background

Giant cell tumour (GCT) is an invasive benign bone tumour, and the incidence of pulmonary metastasis is rare. We are aiming to analyze risk factors of pulmonary metastasis and clinical prognosis for giant cell tumour patients with pulmonary metastasis.

Method

We performed a retrospective study of 310 patients with GCT between December 2004 and December 2016. Risk factors of pulmonary metastasis were analyzed by univariate and multivariate logistic regression analysis. Then, the influence of risk factors of overall LR (local recurrence), recurrent tumor at presentation, LR after our therapy, and with soft tissue mass on the pulmonary metastasis-free survival rates was analyzed.

Results

The mean follow-up of the present cohort was 45.6 ± 35.3 months (median, 36.6 months; range, 6.1–193.4 months). Eighteen (5.8%) of 310 patients developed pulmonary metastasis. The average interval from surgery of primary tumour to detection of pulmonary metastasis was 15 months. Multivariate logistic regression analysis showed overall local recurrence was the independent risk factor of developing pulmonary metastasis. Among 18 patients with pulmonary metastasis, sixteen cases had history of local recurrence (88.9%, 16/18), including eleven (68.8%, 11/16) with local recurrence at presentation before receiving our therapy and seven (43.8%, 7/16) with local recurrence after receiving treatment in our hospital. Time to local recurrence had obvious difference between patients with and without pulmonary metastasis. Patients with pulmonary metastasis were prone to recur earlier. Furthermore, overall local recurrence, local recurrence after our therapy, recurrent tumor at presentation, and tumour with a soft tissue mass showed statistical differences in the pulmonary metastasis-free survival rates.

Conclusions

Giant cell tumour patients with soft tissue mass and overall local recurrence are prone to develop pulmonary metastasis. Although giant cell tumour is a benign tumor, more attention should be paid to the problem of pulmonary metastatic lesions, and chest CT scan should be recommended during follow-up.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Kito M, Matusmoto S, Ae K et al (2017) Pulmonary metastasis from giant cell tumor of bone: clinical outcome prior to the introduction of molecular target therapy. Jpn J Clin Oncol 47:529–534

    Article  Google Scholar 

  2. Wang B, Chen W, Xie XB et al (2017) Development and validation of a prognostic index to predict pulmonary metastasis of giant cell tumor of bone. Oncotarget 8:108054–108063

    Article  Google Scholar 

  3. Rosario M, Kim HS, Yun JY et al (2017) Surveillance for lung metastasis from giant cell tumor of bone. J Surg Oncol 116:907–913

    Article  Google Scholar 

  4. Yang Y, Huang Z, Niu X et al (2017) Clinical characteristics and risk factors analysis of lung metastasis of benign giant cell tumor of bone. J Bone Oncol 7:23–28

    Article  Google Scholar 

  5. Chan CM, Adler Z, Reith JD et al (2015) Risk factors for pulmonary metastases from giant cell tumor of bone. J Bone Joint Surg Am 97:420–428

    Article  Google Scholar 

  6. Dominkus M, Ruggieri P, Bertoni F et al (2006) Histologically verified lung metastases in benign giant cell tumours--14 cases from a single institution. Int Orthop 30:499–504

    Article  CAS  Google Scholar 

  7. Viswanathan S, Jambhekar NA (2010) Metastatic giant cell tumor of bone: are there associated factors and best treatment modalities? Clin Orthop Relat Res 468:827–833

    Article  Google Scholar 

  8. Bertoni F, Bacchini P, Staals EL (2003) Malignancy in giant cell tumor of bone. Cancer 97:2520–2529

    Article  Google Scholar 

  9. Kay RM, Eckardt JJ, Seeger LL et al (1994) Pulmonary metastasis of benign giant cell tumor of bone. Clin Orthop Relat Res 302:219–230

    Google Scholar 

  10. Guo W, Sun X, Zang J et al (2012) Intralesional excision versus wide resection for giant cell tumor involving the acetabulum: which is better? Clin Orthop Relat Res 470:1213–1220

    Article  Google Scholar 

  11. Gupta R, Seethalakshmi V, Jambhekar NA et al (2008) Clinicopathologic profile of 470 giant cell tumors of bone from a cancer hospital in western India. Ann Diagn Pathol 12:239–248

    Article  CAS  Google Scholar 

  12. Tubbs WS, Brown LR, Beabout JW et al (1992) Benign giant-cell tumor of bone with pulmonary metastases-clinical findings and radiologic appearance of radiologic appearance of metastases in 13 cases. AJR Am J Roentgenol 158:331–334

    Article  CAS  Google Scholar 

  13. Sung HW, Kuo DP, Shu WP et al (1982) Giant-cell tumor of bone: analysis of two hundred and eight cases in Chinese patients. J Bone Joint Surg Am 64:755–761

    Article  CAS  Google Scholar 

  14. Kremen TJ Jr, Bernthal NM, Eckardt MA et al (2012) Giant cell tumor of bone: are we stratifying results appropriately? Clin Orthop Relat Res 470:677–683

    Article  Google Scholar 

  15. Bertoni F, Present D, Enneking WF (1985) Giant-cell tumor of bone with pulmonary metastases. J Bone Joint Surg Am 67:890–900

    Article  CAS  Google Scholar 

  16. Errani C, Ruggieri P, Asenzio MA et al (2010) Giant cell tumor of the extremity: a review of 349 cases from a single institution. Cancer Treat Rev 36:1–7

    Article  Google Scholar 

  17. Niu X, Zhang Q, Hao L et al (2012) Giant cell tumor of the extremity: retrospective analysis of 621 Chinese patients from one institution. J Bone Joint Surg Am 94:461–467

    Article  Google Scholar 

  18. van der Heijden L, Dijkstra PD, Campanacci DA et al (2013) Giant cell tumor with pathologic fracture: should we curette or resect? Clin Orthop Relat Res 471:820–829

    Article  Google Scholar 

  19. Cheng JC, Johnston JO (1997) Giant cell tumor of bone prognosis and treatment of pulmonary metastases. Clin Orthop Relat Res 338:205–214

    Article  Google Scholar 

  20. Chen CC, Liau CT, Chang CH, Hsu YH, Shih HN (2016) Giant cell tumors of the bone with pulmonary metastasis. Orthopedics 39:e68–e73

    Article  Google Scholar 

  21. Donthineni R, Boriani L, Ofluoglu O et al (2009) Metastatic behaviour of giant cell tumour of the spine. Int Orthop 33:497–501

    Article  Google Scholar 

  22. Faisham WI, Zulmi W, Halim AS et al (2006) Aggressive giant cell tumour of bone. Singap Med J 47:679–683

    CAS  Google Scholar 

  23. Ng ES, Saw A, Sengupta S, Nazarina AR et al (2006) Giant cell tumour of bone with late presentation-review of treatment and outcome. J Orthop Surg (Hong Kong) 10:120–128

    Article  Google Scholar 

  24. Turcotte RE, Wunder JS, Isler MH et al (2002) Giant cell tumor of long bone-a Canadian sarcoma group study. Clin Orthop Relat Res 397:248–258

    Article  Google Scholar 

  25. Becker WT, Dohle J, Bernd L et al (2008) Local recurrence of giant cell tumor of bone after intralesional treatment with and without adjuvant therapy. J Bone Joint Surg Am 90:1060–1067

    Article  Google Scholar 

  26. Lackman RD, Crawford EA, King JJ et al (2009) Conservative treatment of Campanacci grade III proximal humerus giant cell tumors. Clin Orthop Relat Res 467:1355–1359

    Article  Google Scholar 

  27. Bai WZ, Guo SB, Zhao W et al (2019) Comparison of outcomes of 2 surgical treatments for proximal humerus giant cell tumors: a multicenter retrospective study. J Shoulder Elb Surg 28:2103–2112

    Article  Google Scholar 

  28. Quattrini I, Pollino S, Pazzaglia L et al (2015) Prognostic role of nuclear factor/IB and bone remodeling proteins in metastatic giant cell tumor of bone: a retrospective study. J Orthop Res 33:1205–1211

    Article  CAS  Google Scholar 

  29. Campanacci M, Baldini N, Boriani S et al (1987) Giant-cell tumor of bone. J Bone Joint Surg Am 69:106–114

    Article  CAS  Google Scholar 

  30. Errani C, Tsukamoto S, Mavrogenis AF (2017) How safe and effective is denosumab for bone giant cell tumour? Int Orthop 41:2397–2400

    Article  Google Scholar 

  31. Tsukamoto S, Mavrogenis AF, Leone G et al (2019) Denosumab does not decrease the risk of lung metastases from bone giant cell tumour. Int Orthop 43:483–489

    Article  Google Scholar 

  32. Tsukamoto S, Mavrogenis AF, Tanzi P et al (2019) Similar local recurrence but better function with curettage versus resection for bone giant cell tumor and pathological fracture at presentation. J Surg Oncol 119:864–872

    Article  Google Scholar 

  33. Tsukamoto S, Mavrogenis AF, Tanzi P et al (2020) Denosumab for bone giant cell tumor of the distal radius. Orthopedics 43:284–291

    Article  Google Scholar 

  34. Tsukamoto S, Tanaka Y, Mavrogenis AF et al (2020) Is treatment with denosumab associated with local recurrence in patients with giant cell tumor of bone treated with curettage? A systematic review. Clin Orthop Relat Res 478:1076–1085

    Article  Google Scholar 

  35. Tsukamoto S, Mavrogenis AF, Tanzi P et al (2020) Curettage as first surgery for bone giant cell tumor: adequate surgery is more important than oncology training or surgical management by high volume specialized teams. Eur J Orthop Surg Traumatol 30:3–9

    Article  Google Scholar 

Download references

Funding

This work was supported by the Natural Science Foundation of China (NO: 81702657) and Beijing Municipal Science & Technology Commission (No: Z181100001918025).

Author information

Authors and Affiliations

  1. Musculoskeletal Tumor Center, Peking University People’s Hospital, No. 11 Xizhimen South Street, Beijing, 100044, China

    Jun Wang, Xingyu Liu, Yi Yang, Rongli Yang, Xiaodong Tang, Taiqiang Yan & Wei Guo

Authors
  1. Jun Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xingyu Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yi Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rongli Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Xiaodong Tang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Taiqiang Yan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Wei Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wei Guo.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, J., Liu, X., Yang, Y. et al. Pulmonary metastasis of giant cell tumour: a retrospective study of three hundred and ten cases. International Orthopaedics (SICOT) 45, 769–778 (2021). https://doi.org/10.1007/s00264-020-04907-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-020-04907-0

Keywords

Search

Navigation