Clinicopathological analyses of primary bone tumors, categorized as intermediate group or low-grade

• Project/Area Number: 17K08747
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Human pathology
• Research Institution: Kyoto Prefectural University of Medicine
• Principal Investigator: Konishi Eiichi 京都府立医科大学, 医学(系)研究科(研究院), 准教授 (50186714)
• Co-Investigator(Kenkyū-buntansha): 眞能 正幸 独立行政法人国立病院機構大阪医療センター(臨床研究センター), その他部局等, 機関長・部門長クラス (10183956) ; 森永 友紀子 京都府立医科大学, 医学(系)研究科(研究院), 助教 (20729404) ; 長田 盛典 地方独立行政法人大阪府立病院機構大阪国際がんセンター(研究所), その他部局等, 病理・細胞診断科副部長 (30467922)
• Project Period (FY): 2017-04-01 – 2023-03-31
• Project Status: Completed (Fiscal Year 2022)
• Budget Amount: ¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000); Fiscal Year 2021: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000); Fiscal Year 2020: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000); Fiscal Year 2019: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000); Fiscal Year 2018: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000); Fiscal Year 2017: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
• Keywords: 骨巨細胞腫 / 中間性原発性骨腫瘍 / 再発 / リスク因子 / 統計解析 / 病理組織像 / 原発性骨腫瘍 / 病理組織 / 再発因子 / 再再発因子 / デノスマブ / 放射線画像 / 中間性群 / 低悪性度 / 予後 / 臨床病理学

Outline of Final Research Achievements

Giant cell tumor of bone is an intermediate tumor that may show local recurrence and/or metastasis. We performed a clinicopathological analysis of 213 cases, having primary surgery, and statistically elucidated the predicting factors for recurrence (62 cases) and 2nd relapse (14 cases). As a result, Cox's hazard univariate analysis revealed that six characteristics, such as, younger age, curettage, frequent mitosis, less interstitial hemorrhage, no ischemic necrosis, and more vascular invasion, were significant predicting factors for the first recurrence. In multivariate analysis, the five features other than curettage were significant. We tried to elucidate the risk factors for 2nd relapse in 1st recurrent patients treated with surgery, but no significant factors were found within above mentioned five features, being significant in analysis of the first recurrence. The only significant risk factor for 2nd relapse was the administration of denosumab, a therapeutic drug for this tumor.

Academic Significance and Societal Importance of the Research Achievements

骨巨細胞腫の再発・転移を予想因子が分れば、治療戦略に大きな変化をもたらす。本研究は、初回手術例では、年齢やいくつかの組織所見が局所再発の予見に役立つことが示された。組織学的所見は日ごろの病理診断の際に容易に評価することが可能なものばかりで、診療への応用がすぐにでも可能である。一方、初回再発に有意に関与した因子は、再発術後再々発に有意に関与しなかった。初回再発後の治療法には掻爬や切除の手術と、さらにdenosumabなどの薬剤を単独あるいは手術と組み合わせた治療などがあるが、手術例に限ると同薬剤の投与は再々発の有意なリスク因子となった。同薬剤の投与法については今後検討を要する。

Research Products

• [Journal Article] Giant cell tumor of bone - Analysis of 213 cases involving extra‐craniofacial bones (2021)
  • Author(s): Konishi Eiichi、Outani Hidetatsu、Mano Masayuki、Nagata Shigenori、Shirai Toshiharu、Naka Norifumi、Hori Yumiko、Takenaka Satoshi、Haga Hironori、Toguchida Junya、Kakunaga Shigeki、Kuwae Yuko、Hoshi Manabu、Inoue Takeshi、Aono Masanari、Morinaga Yukiko、Nakashima Yasuaki
  • Journal Title: Pathology International Volume: 71 Issue: 8 Pages: 500-511
  • DOI: 10.1111/pin.13107
  • Peer Reviewed / Open Access
• [Presentation] 骨巨細胞腫 - 再発62例の解析 (2023)
  • Author(s): 本田 水月、森永 友紀子、長田 盛典、眞能 正幸、小西 英一
  • Organizer: 第112回日本病理学会総会
• [Presentation] Giant Cell Tumor of Extracraniofacial Bone -Clinicopathological Analysis of 263 Cases- (2020)
  • Author(s): Eiichi Konishi, Yasuaki Nakashima, Masayuki Mano, Shigenori Nagata, Yuko Kuwae, Yumiko Hori, Takeshi Inoue, Hironori Haga, Yukiko Morinaga, Hidetatsu Outani, Toshiharu Shirai, Shigeki Kakunaga, Norifumi Naka, Masanari Aono, Manabu Hoshi, Jyunya Toguchida
  • Organizer: United States & Canadian Academy of Pathology 109th Annual Meeting
  • Int'l Joint Research