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Role of Zoledronic Acid Supplementation in Reducing Post-Surgical Recurrence of Giant Cell Tumor of Bone: A Meta-Analysis of Comparative Studies

Zoledronic acid is a bisphosphonate that has recently gained interest in adjuvant therapy for giant cell tumor of bone (GCTB). It has an apoptotic effect on osteoclasts that are precursors of GCTB. However, the evidence suggesting the role of zoledronic acid in preventing GCTB recurrence is mixed, a...

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Autores principales: Kumar, Arvind, Sinha, Siddhartha, Haider, Yawar, Jameel, Javed, Kumar, Sandeep
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8403108/
https://www.ncbi.nlm.nih.gov/pubmed/34471584
http://dx.doi.org/10.7759/cureus.16742
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author Kumar, Arvind
Sinha, Siddhartha
Haider, Yawar
Jameel, Javed
Kumar, Sandeep
author_facet Kumar, Arvind
Sinha, Siddhartha
Haider, Yawar
Jameel, Javed
Kumar, Sandeep
author_sort Kumar, Arvind
collection PubMed
description Zoledronic acid is a bisphosphonate that has recently gained interest in adjuvant therapy for giant cell tumor of bone (GCTB). It has an apoptotic effect on osteoclasts that are precursors of GCTB. However, the evidence suggesting the role of zoledronic acid in preventing GCTB recurrence is mixed, and therefore, a consensus is yet to be established. The purpose of the current meta-analysis was to analyze the impact of zoledronic acid supplementation on tumor recurrence in surgical treated GCTB. A systematic search was conducted on PubMed, Embase, and Web of Science databases to identify studies that analyzed the impact of local or systemic zoledronic acid supplementation on clinical outcomes in surgically treated GCTB. The data from the comparative studies were pooled and analyzed to investigate the association of zoledronic acid supplementation with tumor recurrence. Additionally, other factors such as age, gender, soft tissue extension, polymethyl methacrylate (PMMA) cement application, recurrent presentation, and extended curettage were also investigated for any association with tumor recurrence. Of the 271 results, 13 unique studies reported the clinical outcomes in GCTB. Seven studies compared the outcomes of zoledronic acid supplementation with control groups. Six studies presented the tumor recurrence-related data among the comparison groups. The zoledronic acid supplementation was associated with significantly lower tumor recurrence rates (p = 0.007). Additionally, a significant association of soft tissue extension and non-usage of PMMA cement with tumor recurrence were observed. The current meta-analysis suggests that zoledronic acid supplementation reduces tumor recurrence rates in surgically treated GCTB. We, therefore, recommend the use of zoledronic acid following aggressive extended curettage of the tumor. Further, well-planned randomized controlled trials will help strengthen this evidence.
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spelling pubmed-84031082021-08-31 Role of Zoledronic Acid Supplementation in Reducing Post-Surgical Recurrence of Giant Cell Tumor of Bone: A Meta-Analysis of Comparative Studies Kumar, Arvind Sinha, Siddhartha Haider, Yawar Jameel, Javed Kumar, Sandeep Cureus Orthopedics Zoledronic acid is a bisphosphonate that has recently gained interest in adjuvant therapy for giant cell tumor of bone (GCTB). It has an apoptotic effect on osteoclasts that are precursors of GCTB. However, the evidence suggesting the role of zoledronic acid in preventing GCTB recurrence is mixed, and therefore, a consensus is yet to be established. The purpose of the current meta-analysis was to analyze the impact of zoledronic acid supplementation on tumor recurrence in surgical treated GCTB. A systematic search was conducted on PubMed, Embase, and Web of Science databases to identify studies that analyzed the impact of local or systemic zoledronic acid supplementation on clinical outcomes in surgically treated GCTB. The data from the comparative studies were pooled and analyzed to investigate the association of zoledronic acid supplementation with tumor recurrence. Additionally, other factors such as age, gender, soft tissue extension, polymethyl methacrylate (PMMA) cement application, recurrent presentation, and extended curettage were also investigated for any association with tumor recurrence. Of the 271 results, 13 unique studies reported the clinical outcomes in GCTB. Seven studies compared the outcomes of zoledronic acid supplementation with control groups. Six studies presented the tumor recurrence-related data among the comparison groups. The zoledronic acid supplementation was associated with significantly lower tumor recurrence rates (p = 0.007). Additionally, a significant association of soft tissue extension and non-usage of PMMA cement with tumor recurrence were observed. The current meta-analysis suggests that zoledronic acid supplementation reduces tumor recurrence rates in surgically treated GCTB. We, therefore, recommend the use of zoledronic acid following aggressive extended curettage of the tumor. Further, well-planned randomized controlled trials will help strengthen this evidence. Cureus 2021-07-29 /pmc/articles/PMC8403108/ /pubmed/34471584 http://dx.doi.org/10.7759/cureus.16742 Text en Copyright © 2021, Kumar et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Orthopedics
Kumar, Arvind
Sinha, Siddhartha
Haider, Yawar
Jameel, Javed
Kumar, Sandeep
Role of Zoledronic Acid Supplementation in Reducing Post-Surgical Recurrence of Giant Cell Tumor of Bone: A Meta-Analysis of Comparative Studies
title Role of Zoledronic Acid Supplementation in Reducing Post-Surgical Recurrence of Giant Cell Tumor of Bone: A Meta-Analysis of Comparative Studies
title_full Role of Zoledronic Acid Supplementation in Reducing Post-Surgical Recurrence of Giant Cell Tumor of Bone: A Meta-Analysis of Comparative Studies
title_fullStr Role of Zoledronic Acid Supplementation in Reducing Post-Surgical Recurrence of Giant Cell Tumor of Bone: A Meta-Analysis of Comparative Studies
title_full_unstemmed Role of Zoledronic Acid Supplementation in Reducing Post-Surgical Recurrence of Giant Cell Tumor of Bone: A Meta-Analysis of Comparative Studies
title_short Role of Zoledronic Acid Supplementation in Reducing Post-Surgical Recurrence of Giant Cell Tumor of Bone: A Meta-Analysis of Comparative Studies
title_sort role of zoledronic acid supplementation in reducing post-surgical recurrence of giant cell tumor of bone: a meta-analysis of comparative studies
topic Orthopedics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8403108/
https://www.ncbi.nlm.nih.gov/pubmed/34471584
http://dx.doi.org/10.7759/cureus.16742
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