Orthopedics. 2021 Nov-Dec;44(6):e707-e712. doi: 10.3928/01477447-20211001-01. Epub 2021 Oct 1.
Approximately 2% to 9% of giant cell tumor of bone (GCTB) metastasizes systemically, mainly to the lungs. The biological behaviors and clinical courses of lung metastases are difficult to predict, and their treatment recommendations vary, including metastasectomy and non-metastasectomy with chemotherapy (denosumab, interferon-alfa, bisphosphonates), with radiation therapy, or with observation alone. However, it is unclear whether metastasectomy for GCTB lung metastases decreases the mortality rate of these patients. Therefore, the authors performed this systematic review to compare metastasectomy and non-metastasectomy for GCTB patients with operable lung metastasis. Of the 919 relevant studies, 16 studies (138 patients) were included for analysis; 61.6% of patients had metastasectomy and 38.4% had non-metastasectomy. Analysis showed that mortality rates were similar for the patients who had metastasectomy compared with those who did not; the proportion of patients who died of disease was 7.1% in the metastasectomy group and 17.0% in the non-metastasectomy group, with an overall pooled odds ratio of 0.64 (=.36). Therefore, physicians should reconsider the potential risks and benefits of metastasectomy for patients with GCTB and lung metastasis, because metastasectomy does not reduce the mortality rate in these patients. [. 2021;44(6):e707-e712.].
大约 2%至 9%的骨巨细胞瘤（GCTB）会发生全身转移，主要转移到肺部。肺部转移的生物学行为和临床过程难以预测，其治疗建议也各不相同，包括转移灶切除术和非转移灶切除术联合化疗（地舒单抗、干扰素-α、双膦酸盐）、放疗或单纯观察。然而，对于 GCTB 肺转移患者，转移灶切除术是否能降低死亡率尚不清楚。因此，作者进行了这项系统评价，以比较可手术治疗的 GCTB 肺转移患者的转移灶切除术和非转移灶切除术。在 919 项相关研究中，有 16 项研究（138 名患者）纳入分析；61.6%的患者行转移灶切除术，38.4%的患者行非转移灶切除术。分析显示，行转移灶切除术的患者与未行转移灶切除术的患者死亡率相似；转移灶切除术组中死于疾病的患者比例为 7.1%，非转移灶切除术组为 17.0%，总体汇总比值比为 0.64（95%CI：0.36）。因此，对于 GCTB 合并肺转移的患者，医生应重新考虑转移灶切除术的潜在风险和获益，因为转移灶切除术并不能降低这些患者的死亡率。[Radiology. 2021;44(6):e707-e712.]。
