骨巨细胞瘤（GCTB）是一种局部侵袭性肿瘤，病灶内刮除后复发的可能性很高。 RANKL 抑制剂狄诺塞麦的引入已显示出促进关节保留手术的潜力。然而，人们对其对局部复发率的影响存在担忧。本研究旨在评估术前联合狄诺塞麦联合辅助微波消融（MWA）治疗高危GCTB的有效性和安全性。我们对19例接受术前狄诺塞麦治疗并随后进行刮宫术的高危GCTB患者进行回顾性分析和辅助 MWA。主要结局指标是局部复发率，次要结局包括肌肉骨骼肿瘤协会 (MSTS) 评分评估的功能状态和治疗的安全性。在这项回顾性分析中，我们评估了 19 名高危 GCTB 患者的结局术前接受狄诺塞麦和辅助 MWA 治疗。中位随访时间为33.1个月，3名患者（15.8%）在术后中位21.6个月时出现局部复发，两年时局部无复发生存率为81.2%。值得注意的是，没有患者出现肺转移，所有复发均通过重复刮除和 MWA 成功控制，平均 MSTS 评分为 27.3。没有患者因肿瘤复发而需要关节置换，关节保留率达100%。术前狄诺塞麦联合辅助MWA是治疗高危GCTB的可行有效策略，可提供有效的局部控制并保留关节功能。这种方法可能为保留关节至关重要的年轻患者提供一种手术替代方案。© 2024。作者。

Giant cell tumor of bone (GCTB) is a locally aggressive neoplasm with a high propensity for recurrence following intralesional curettage. The introduction of denosumab, a RANKL inhibitor, has shown potential in facilitating joint-sparing surgery. However, concerns exist regarding its impact on local recurrence rates. This study aimed to evaluate the efficacy and safety of combined preoperative denosumab with adjuvant microwave ablation (MWA) for the treatment of high-risk GCTB.We conducted a retrospective review of 19 patients with high-risk GCTB who underwent preoperative denosumab treatment followed by curettage and adjuvant MWA. The primary outcome measure was the local recurrence rate, with secondary outcomes including functional status assessed by the Musculoskeletal Tumor Society (MSTS) score and safety profile of the treatment.In this retrospective analysis, we evaluated the outcomes of 19 patients with high-risk GCTB treated with preoperative denosumab and adjuvant MWA. The median follow-up duration was 33.1 months, 3 patients (15.8%) experienced local recurrence at a median of 21.6 months postoperatively and the local recurrence-free survival was 81.2% at two years. Notably, no patient developed lung metastasis, and all recurrences were successfully managed with repeat curettage and MWA, with a mean MSTS score of 27.3. No patient required joint replacement due to tumor recurrence, resulting in a 100% joint preservation rate.The combination of preoperative denosumab and adjuvant MWA is a feasible and effective strategy for the management of high-risk GCTB, providing effective local control with preserved joint function. This approach may offer a surgical alternative for young patients where joint preservation is paramount.© 2024. The Author(s).