Synovial sarcoma of the extremities and trunk: A long lasting disease

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 10073-10073
Author(s):  
O. Merimsky ◽  
V. Soyfer ◽  
A. Goffman ◽  
J. Issakov ◽  
J. Bickels ◽  
...  
Keyword(s):  
Overall Survival ◽  
Local Recurrence ◽  
Synovial Sarcoma ◽  
Recurrence Free Survival ◽  
Rare Type ◽  
Free Survival ◽  
Delay In Diagnosis ◽  
Systemic Recurrence ◽  
Orthopedic Oncology

10073 Background: Synovial sarcoma (SS) of an extremity or trunk is a relatively rare type of soft tissue sarcoma. SS most commonly affects adolescents and young adults. SS usually originates at an extremity, carries a t(X;18)(p11;q11) translocation, and approached by limb sparing surgery, radiation therapy, and chemotherapy. Methods: A retrospective analysis of clinical and histopathological data of 73 patients with proven SS, treated at the National Unit of Orthopedic Oncology, from January 1991 through December 2004 was performed. Results: At a median follow-up time of 6 years, a local-recurrence was observed in 17.8% of the patients, while systemic recurrence in 35.6% (local-only in 6.8 %, systemic-only in 24.6 %, and combined in 11%). Accumulation of events of local and systemic recurrence following a limb sparing approach, did not reach a plateau even after 192 months from diagnosis. The 10-year local recurrence free survival (LRFS), the 10-year systemic recurrence-free survival (SRFS), and the 10-year overall survival (OS) were 78%, 68%, and 61%, respectively. The median SRFS time was 180 months, while the median LRFS and OS have not been reached yet. LRFS was significantly better for ILP treated patients; SRFS was influenced by a shorter delay in diagnosis. Conclusions: The practical aspects of our observations are the need for long-term follow-up for diagnosis of recurrence, the fact that not all local or distant recurrences are necessarily associated with shortening of overall survival, and the important role of induction ILP with TNF in cases of extremity SS. No significant financial relationships to disclose.

Intraoperative versus external beam boost for breast cancer: A matched-pair analysis.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1120-1120 ◽  
Author(s):  
Elena Sperk ◽  
Daniela Astor ◽  
Grit Welzel ◽  
Axel Gerhardt ◽  
Marc Suetterlin ◽  
...  
Keyword(s):  
Overall Survival ◽  
Local Recurrence ◽  
Breast Conserving Surgery ◽  
Matched Pair ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Matched Pair Analysis ◽  
Pair Analysis ◽  
Local Recurrence Free Survival

1120 Background: After breast conserving surgery, radiotherapy leads to a better overall survival. In addition to whole breast radiotherapy (WBRT) a boost to the tumor bed leads to a better local control. The tumor bed boost is usually added after WBRT or can be done intraoperative (IORT). Belletti et al. (Clin Cancer Res., 2008) described positive effects, an antitumoral effect and modulation of microenvironment after IORT with 50kV x-rays. A matched pair analysis was performed to investigate the impact of IORT boost on overall survival compared to standard external beam boost. Methods: Between 2002 – 2009, 370 patients were treated for breast cancer with WBRT + boost (external beam (EBRT) boost n = 146, IORT boost n =224). A matched pair analysis (1:1 propensity score matching for age, TNM, grading, hormonal treatment and chemotherapy) for overall survival and local recurrence free survival could be done for 53 pairs. All patients underwent breast conserving surgery and WBRT with 46-50Gy. 53 patients received an EBRT boost with 16Gy (2Gy/fraction, dedicated linear accelerator) and 53 patients received an IORT boost with 20Gy (INTRABEAM system, 50kV x-rays). Median follow-up was 6 months (range, 1-77 months) for the EBRT boost patients and 56 months (range, 2-97 months) for IORT boost patients. Kaplan Meier estimates were performed for overall survival and local recurrence free survival. Results: IORT boost patients had a longer follow-up than EBRT boost patients. Despite the difference in follow-up times, there was a strong trend towards better overall survival after IORT boost (90.2% vs. 62.3%, p = 0.375). One local recurrence was present in each group (EBRT boost after 15 months, local recurrence free survival 95%; IORT boost after 12 months, local recurrence free survival 98.1%). Conclusions: IORT given as a boost seems to have a positive impact on overall survival in breast cancer patients after breast conserving surgery. To identify such an effect a prospective randomized trial should be conducted.

An open-labeled, multicentric clinical study of cetuximab combined with intensity-modulated radiotherapy (IMRT) plus concurrent chemotherapy in locoregionally advanced (LA) nasopharyngeal carcinoma (NPC): A 2-year follow-up report.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 5535-5535 ◽  
Author(s):  
Chun-yan Chen ◽  
Chong Zhao ◽  
Li Gao ◽  
Jin-yi Lang ◽  
Jian-ji Pan ◽  
...  
Keyword(s):  
Overall Survival ◽  
Disease Free Survival ◽  
Concurrent Chemotherapy ◽  
Stage Iii ◽  
Chinese Patients ◽  
Recurrence Free Survival ◽  
Spontaneous Bleeding ◽  
Cervical Lymph Nodes ◽  
Free Survival

5535 Background: To evaluate the safety and efficacy outcomes of concurrent cetuximab plus IMRT and cisplatin in Chinese patients with LA NPC. Methods: Patients with primary stage III-IVb (UICC/AJCC 2002 staging system) and non-keratinizing NPC were enrolled in this prospective, multicentric, phase II study. Cisplatin (80mg/m2,q3week) and cetuximab (400mg/m2 one w before radiation, and then 250mg/m2/w) were given concurrently. The prescription dose of IMRT to GTVnx (primary tumor in nasopharynx) was 66 Gy - 75.9 Gy, GTVnd (positive cervical lymph nodes) was 60 Gy - 70Gy, The response rate was evaluated according to RECIST 1.0 criteria, and adverse events (AEs) were graded according to NCI CTCAE V3.0 criteria. Results: From July 2008 to April 2009, 100 patients were enrolled (74 male), with median age of 43 years. The proportion of stage III, IVa and IVb patients were 71%, 22% and 7% respectively. 99% of enrolled patients completed the planned treatment. AEs were within the expected range and manageable. No toxic death occurred during the treatment. Acneiform skin eruptions, mucositis, in-field dermatitis, xerostomia and neucopenia were the most common seen AEs, with 64% grade 2/3 acneiform eruptions, 26% grade 2/3 in-field dermatitis, 90% ≥ grade 2 mucositis (2 cases of grade 4 mucositis with spontaneous bleeding), 40% ≥ grade 2 xerostomia and 8% grade 2/3 neucopenia. With a median follow-up time of 23.5 months, the 2 year overall survival (OS), disease-free survival (DFS), local recurrence-free survival, regional (cervical lymph node) recurrence free survival and distant metastasis-free survival rates for the ITT population were 91%, 89%, 90%, 90% and 89%, respectively Multivariate analysis showed that N stage was the only prognostic factor for OS (p=0.0392, HR=2.946) and DFS (p=0.0062, HR=4.246) in these patients. Conclusions: Cetuximab combined with IMRT plus concurrent cisplatin in patients with LA NPC shows satisfactory 2-year locoregional control rate and 2-year overall survival. The combination seems to be well tolerated with a manageable side-effect profile.

The effect of complete surgical staging and adjuvant chemotherapy on survival in stage I, grade 1 and 2 endometrioid ovarian carcinoma

2021 ◽  
pp. ijgc-2021-003112
Author(s):  
Brenna E Swift ◽  
Allan Covens ◽  
Victoria Mintsopoulos ◽  
Carlos Parra-Herran ◽  
Marcus Q Bernardini ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Stage I ◽  
Low Grade ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Stage Ia ◽  
Endometrioid Ovarian Cancer

ObjectivesTo assess the effect of complete surgical staging and adjuvant chemotherapy on survival in stage I, low grade endometrioid ovarian cancer.MethodsThis retrospective study was conducted at two cancer centers from July 2001 to December 2019. Inclusion criteria were all stage I, grade 1 and 2 endometrioid ovarian cancer patients. Patients with mixed histology, concurrent endometrial cancer, neoadjuvant chemotherapy, and patients who did not undergo follow-up at our centers were excluded. Clinical, pathologic, recurrence, and follow-up data were collected. Cox proportional hazard model evaluated predictive factors. Recurrence-free survival and overall survival were calculated using the Kaplan-Meier method.ResultsThere were 131 eligible stage I patients: 83 patients (63.4%) were stage IA, 5 (3.8%) were stage IB, and 43 (32.8%) were stage IC, with 80 patients (61.1%) having grade 1 and 51 (38.9%) patients having grade 2 disease. Complete lymphadenectomy was performed in 34 patients (26.0%), whereas 97 patients (74.0%) had either partial (n=22, 16.8%) or no (n=75, 57.2%) lymphadenectomy. Thirty patients (22.9%) received adjuvant chemotherapy. Median follow-up was 51.5 (95% CI 44.3 to 57.2) months. Five-year recurrence-free survival was 88.0% (95% CI 81.6% to 94.9%) and 5 year overall survival was 95.1% (95% CI 90.5% to 99.9%). In a multivariable analysis, only grade 2 histology had a significantly higher recurrence rate (HR 3.42, 95% CI 1.03 to 11.38; p=0.04). There was no difference in recurrence-free survival (p=0.57) and overall survival (p=0.30) in patients with complete lymphadenectomy. In stage IA/IB, grade 2 there was no benefit of adjuvant chemotherapy (p=0.19), and in stage IA/IB, low grade without complete surgical staging there was no benefit of adjuvant chemotherapy (p=0.16). Twelve patients (9.2%) had recurrence; 3 (25%) were salvageable at recurrence and are alive with no disease.ConclusionsPatients with stage I, low grade endometrioid ovarian cancer have a favorable prognosis, and adjuvant chemotherapy and staging lymphadenectomy did not improve survival.

scholarly journals Breast Conservation in Breast Cancer: A Bangladesh Experience

2019 ◽  
Vol 19 (2) ◽  
pp. 55-60
Author(s):  
Parveen shahida Akhtar ◽  
Syeeda Hasina Azam ◽  
Syed Khalid Hasan ◽  
Zafor Mohammad Masud ◽  
Nazrina Khatun ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Local Recurrence ◽  
Hormone Therapy ◽  
Distant Metastasis ◽  
Locally Advanced ◽  
Breast Conserving Surgery ◽  
Breast Conserving Treatment ◽  
Free Survival

Background: Breast cancer is one of the most common cancers in Bangladeshi women. Breast sacrificing treatment is still now the common practice in our country. Now a day’s breast conservative treatment is the standard treatment of breast cancer without compromising the survival. Objective: To observe local recurrence and distant metastasis free survival and overall survival of patients with breast cancer. Methods: Between January 1996 and December 2010, breast conserving treatment was carried out in 237 female patients with breast cancer in different Institutions of Bangladesh. Clinical staging was recorded by physical examination, relevant investigations as well as surgical records. Revised breast conserving surgery was carried out in those who had positive surgical margins or palpable disease. The patients with large but operable cancer or locally advanced cancer were treated by neoadjuvant chemotherapy followed by breast conserving surgery. Systemic adjuvant therapy (chemotherapy and or hormone therapy) and adjuvant radiotherapy were given in all patients. After completion of treatment, the patients were followed up with a standard protocol and data were compiled and analysed. Results: Among 237 patients who underwent breast conserving therapy 13 patients were excluded from the study for various reasons. Total 224 female patients with breast cancer who followed all the treatment schedules and attended for regular follow up were included in the study. They were between 22- 74 years of age, mean age 42.35 years; premenopausal 152 (68%). Sixty five percent (146 patients) was localized cancer (T1-2N0M0), 31.6% was regional cancer (T1-3N1M0), five cases were locally advanced stage (T4bN12M0) and two metastastatic cancer (T2-3N1M1).  All most all (98%) were Infiltrating duct cell carcinoma except four which were Intraductal carcinoma in situ (IDIS).  Estrogen and progesterone receptors were positive in 57% , HER2 positive (+++) in 24% of Patients. Lumpectomy/quandrentectomy with/without axillary clearance was done in 158 patients, revised breast conserving surgery in 53 cases, mastectomy in 8 cases and only biopsy done but no surgical treatment in five cases.Chemotherapy was given in 192 patients (86%); adjuvant 122 cases and neoadjuvant 70 cases. Hormone therapy in 182 patients. Radiotherapy: in 222 cases. Follow up period  was 4 years  to 19 years, median 10 years. Overall survival (OS) and disease free survival (DFS) was 84% and 70% respectively. Local recurrence occurred in 14(6%) cases and distant metastasis in 54 cases (24%). Conclusion: Breast conserving treatment was satisfactory for appropriate case selection and optimized therapy. Survival was no way worse than breast sacrificing treatment. Journal of Surgical Sciences (2015) Vol. 19 (2) : 55-60

Hypofractioned radiotherapy versus conventional radiotherapy for the treatment of multiform glioblastoma in adults over 70 years old

2019 ◽  
Vol 19 (2) ◽  
pp. 193-196
Author(s):  
Adriana Jiménez Cantero ◽  
Jessica Chávez Nogueda ◽  
Fabiola Flores Vázquez ◽  
José Pablo Castillo de la Garza ◽  
Raymundo Hernández Montes de Oca ◽  
...  
Keyword(s):  
Overall Survival ◽  
Median Survival ◽  
Survival Rates ◽  
Recurrence Free Survival ◽  
Duration Of Treatment ◽  
Conventional Radiotherapy ◽  
Free Survival ◽  
Conventional Fractionation ◽  
Global Survival

AbstractAim:Multiform glioblastoma (MG) represents 70% of all gliomas, with half of patients older than 65 years with median survival of 12–18 months, hypofractionation seeks to reduce the intensity and duration of treatment without impacting on survival rates. The objective was to determine the global survival and recurrence-free survival of adults over 70 years old with MG treated with hypofractionated radiotherapy and standard scheme. The review of patients older than 70 years treated with radiotherapy from 2013 to 2016 was performed.Results:Twenty-four patients were analysed, with a median follow-up of 239 days, and there is no difference in overall survival 12·3 versus 10·5 months (p = 0·55) and recurrence-free survival 8·3 versus 3·4 months (p = 0·48) between both schemes, conventional versus hypofractioanted, respectively.Conclusion:The results in this study show that hypofractionated scheme could be comparable in overall survival and recurrence-free survival to conventional fractionation, but a longer patients’ trial should be done.

Adjuvant radiotherapy after primary surgical resection in patients with adrenocortical carcinoma: Retrospective cohort analysis.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 4641-4641
Author(s):  
Mouhammed Amir Habra ◽  
Shamim Ejaz ◽  
Lei Feng ◽  
Prajnan Das ◽  
Ferhat Deniz ◽  
...  
Keyword(s):  
Overall Survival ◽  
Local Recurrence ◽  
Adrenocortical Carcinoma ◽  
Adjuvant Radiotherapy ◽  
Distant Recurrence ◽  
Hazard Ratio ◽  
Control Group ◽  
Recurrence Free Survival ◽  
Free Survival

4641 Background: Adrenocortical carcinoma (ACC) is a rare malignancy with high recurrence and mortality rates. The role of adjuvant radiotherapy (RT) to improve outcome remains unclear. Considering the rarity of ACC, we conducted a historical cohort study to ascertain the effect of adjuvant RT on overall survival and recurrence rates. Methods: Patients were selected from the MD Anderson Cancer Center (MDACC) ACC registry (1998- 2011) who had primary tumor resection with no evidence of distant metastasis at the time of initial diagnosis and a minimum follow-up of 6-months. The adjuvant RT group included patients who received adjuvant RT within 3 months of diagnosis. Control group included patients who did not receive RT and matched based on resection margin status and stage at diagnosis. Results: There were no significant differences between the adjuvant RT group (n=15) and comparison group (n =45) in gender distribution, age, tumor size, functional status, and use of adjuvant mitotane therapy. On multivariate Cox proportional hazard model for overall survival, the adjuvant RT group had hazard ratio of 1.981(95% confidence interval [CI] 0.894-4.391, p=0.0922) compared to the control group. The differences in median time to local recurrence, distant recurrence and of recurrence free survival were not significant between the two groups. In subgroup analysis including only the patients whose initial treatments were from outside of MDACC, RT group (n=15) had hazard ratio of overall survival of 1.604 (95% CI 0.712- 3.613, p=0.2543) compared to group without adjuvant RT (n= 32). Median times to local recurrence, distant recurrence, or of recurrence free survival were also not significantly different between the two groups. Conclusions: To our knowledge, this is the largest single institution report about adjuvant RT use in ACC. In our study, RT did not appear to cause a significant difference in overall survival, recurrence rate, or time to recurrence. However, it is still possible that patients offered adjuvant RT and control groups may have been inherently different. Hence, a prospective study is needed to clarify the role of adjuvant RT in patients with resectable ACC.

Comparison between oncological outcomes of primary versus salvage radical cystectomy for urothelial carcinoma of the bladder.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 585-585
Author(s):  
Seyedeh Sanam Ladi Seyedian ◽  
Zhoobin Bateni ◽  
Soroush T. Bazargani ◽  
Daniel Zainfeld ◽  
Jie Cai ◽  
...  
Keyword(s):  
Overall Survival ◽  
Local Recurrence ◽  
Urothelial Carcinoma ◽  
Radical Cystectomy ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Increased Risk ◽  
Significant Difference ◽  
Carcinoma Of The Bladder ◽  
To Receive

585 Background: This study aims to compare oncologic outcomes among patients who underwent salvage radical cystectomy (sRC) for recurrent urothelial carcinoma (UC) of the bladder following radiotherapy (RT) with primary radical cystectomy (pRC). Methods: We retrospectively reviewed the data of 3705 primary consented cystectomy patients of our IRB-approved bladder cancer database from Jan 1971 to June 2017 who underwent radical cystectomy for urothelial carcinoma of the bladder. Clinical and pathological data at the time of both RT and RC was collected. Patients with non-UCs and those receiving radiation for non-UCs were excluded. Multivariate analyses was performed to identify prognostic factors after RC for overall survival and recurrence-free survival. Results: 3050 patients were identified who underwent radical cystectomy for UC of the bladder. Of these, 128 patients (4.2%) underwent sRC following radiotherapy (RT). Patient characteristics including age, BMI, gender, and comorbidities were similar between the groups. Complications rates between the groups were similar at 30 days (43% sRC vs 39% pRC patients, p=0.41) and 90 days (52% sRC vs 48% pRC, p=0.42). Patients receiving sRC were less likely to receive a continent diversion (p<0.001). Five-year overall survival following sRC was 47% in comparison to 63% for those undergoing pRC (p<0.001) (Fig 1). However, no significant difference in five-year recurrence free survival was found (61% sRC vs 68% pRC; p=0.15). On multivariate analysis, sRC (HR 1.37, p=0.048), pathologic tumor stage ≥pT3a (HR 2.6, P < 0.001) and lymph node metastases (HR 2.5, P < 0.001) were associated with increased risk of local recurrence after radical cystectomy. Conclusions: Patients undergoing sRC are less likely to receive a continent urinary diversion and are at increased risk of local recurrence following cystectomy in comparison to patients receiving primary cystectomy.

scholarly journals Factors Influencing Prognosis After Initial Inadequate Excision (IIE) for Soft Tissue Sarcoma

Sarcoma ◽  
2003 ◽  
Vol 7 (3-4) ◽  
pp. 159-165 ◽  
Author(s):  
Albert N. Van Geel ◽  
Alexander M. M. Eggermont ◽  
Patrick E. J. Hanssens ◽  
Paul I. M. Schmitz
Keyword(s):  
Overall Survival ◽  
Soft Tissue ◽  
Local Recurrence ◽  
Soft Tissue Sarcoma ◽  
Tumor Grade ◽  
Residual Tumor ◽  
Radical Resection ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Local Recurrence Free Survival

Purpose. The influence of initial inadequate excision (IIE) of soft tissue sarcoma (STS) on local control and overall survival is not well established. It is generally believed that an IIE may have a negative impact on both, despite subsequent treatment by radical surgery and radiotherapy. However, data on local recurrence-free survival/overall survival are conflicting and there are no data on the effect of IIE on overall survival.Patients and methods. A retrospective analysis was made of 86 patients with soft tissue sarcoma of the extremities and trunk after an IIE had been performed due to inappropriate work-up. The minimal follow-up was 7 years. Specimens of the subsequent radical resection were evaluated for residual tumor, grade of tumor and complications of IIE. Endpoints were recurrence-free survival and overall survival.Results. Specimens of the subsequent radical resection showed residual tumor in 66 patients (77%). The most common complication after IIE was hematoma. In both univariate and multivariate analyses, grade II/III tumors and complications after IIE are significant negative prognostic factors for local recurrence-free survival (P= 0.008 andP= 0.002, respectively, in the Cox model). For this survival, three prognostic groups could be formed based on grade, or presence or absence of complications. Adjuvant radiotherapy did not change the rate of local recurrence-free survival. For overall survival, only tumor grade is a significant factor (log-rank test).Conclusion. This retrospective study shows that complications associated with an IIE have a significant negative effect on local control, but not on overall survival, because IIE is often the result of inappropriate work-up before surgery. For better diagnosis and therapy STS should be treated in specialized centers.

scholarly journals Comparison of open and laparoscopic radical cystectomy as regards long-term oncological outcomes for bladder cancer

2021 ◽  
Vol 42 (2) ◽  
pp. 123-130
Author(s):  
Thanachai Sirikul ◽  
◽  
Supon Sriplakich ◽  
Akara Amantakul ◽  
◽  
...  
Keyword(s):  
Overall Survival ◽  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Recurrence Free Survival ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Oncological Outcomes ◽  
Open Radical Cystectomy

Objective: Recently, the laparoscopic technique has become widely accepted as a minimally invasive modality which reduces morbidity and provides similar oncological outcomes to open surgery. However, the number of clinical trials comparing laparoscopic and open radical cystectomy are limited. The objectives of this study are to compare the long-term oncological outcomes between open radical cystectomy (ORC) and laparoscopic radical cystectomy (LRC) for bladder cancer. Materials and Methods: Out of 144 radical cystectomy patients admitted to our institute from January 2006 to December 2016, 87 patients were categorized as being in the LRC group, and 57 patients in the ORC group. Baseline characteristics, perioperative variables, and pathology results were collected retrospectively. Oncological outcomes including overall survival (OS), recurrence-free survival (RFS) and cancer-specific survival (CSS) were analyzed and compared between the two groups. Results: The mean age of the patients was 64.19 ± 9.89 years in the ORC group and 61.90 ± 10.47 years in the LRC group. The most frequent urinary diversion procedure in both groups was ileal conduit. All pathology results between the LRC group and the ORC group showed no statistical significance. The median follow-up duration was 57.18 ± 44.68 months in the ORC group and 53.96 ± 34.97 months in the LRC group. There was no statistically significant difference in overall survival (OS), recurrence-free survival (RFS) and cancer-specific survival (CSS) between the groups (p = 0.322, 0.946, and 0.528, respectively). Conclusion: Our study demonstrated that the long-term oncological outcome of LRC is comparable to ORC in the management of bladder cancer. LRC is an alternative option to open radical cystectomy and is safe, effective, and feasible. However, further large comparative studies with adequate long-term follow-up are recommended to support our results.

Neoadjuvant denosumab

2019 ◽  
Vol 101-B (2) ◽  
pp. 170-177 ◽  
Author(s):  
A. Puri ◽  
A. Gulia ◽  
P. Hegde ◽  
V. Verma ◽  
B. Rekhi
Keyword(s):  
High Risk ◽  
Local Recurrence ◽  
Local Control ◽  
Giant Cell Tumour ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
The Mean ◽  
Mean Time ◽  
Local Recurrence Free Survival

Aims The aims of this study were to evaluate the efficacy of preoperative denosumab in achieving prospectively decided intention of therapy in operable giant cell tumour of bone (GCTB) patients, and to document local recurrence-free survival (LRFS). Patients and Methods A total of 44 patients received preoperative denosumab: 22 to facilitate curettage, 16 to facilitate resection, and six with intent of converting resection to curettage. There were 26 male and 18 female patients. The mean age was 27 years (13 to 47). Results The mean number of denosumab treatments was five (2 to 7) per patient. In 42 of 44 patients (95%), denosumab helped to achieve prospectively decided intention. A total of 41 patients were available for follow-up at a mean follow-up of 34 months (24 to 48). There were 12 local recurrences (29%), in 11 patients (11/25, 44%) who had curettage and in one patient (1/16, 6%) who had resection. The mean time to local recurrence was 16 months (8 to 25). The LRFS was 76% at two years: 94% for cases with resection and 64% for cases with curettage (p = 0.013). Conclusion Although local control rates are unlikely to improve with use of preoperative denosumab, a short preoperative course of denosumab can facilitate surgery in certain cases of operable GCTB, with a high risk of local recurrence making curettage or resection technically easier. It may also help in converting a lesion requiring resection to a lesion that could possibly be treated with curettage.

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