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Active surveillance of diffuse-type tenosynovial giant cell tumors: A retrospective, multicenter cohort study.
Spierenburg, Geert; Staals, Eric L; Palmerini, Emanuela; Randall, Robert Lor; Thorpe, Steven W; Wunder, Jay S; Ferguson, Peter C; Verspoor, Floortje G M; Houdek, Matthew T; Bernthal, Nicholas M; Schreuder, Bart H W B; Gelderblom, Hans; van de Sande, Michiel A J; van der Heijden, Lizz.
Afiliación
  • Spierenburg G; Department of Orthopedic Surgery, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: G.Spierenburg@lumc.nl.
  • Staals EL; Third Orthopaedic Clinic and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
  • Palmerini E; Osteooncology, Soft Tissue and Bone Sarcomas, Innovative Therapy Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
  • Randall RL; Department of Orthopaedic Surgery, University of California-Davis, Sacramento, CA, USA.
  • Thorpe SW; Department of Orthopaedic Surgery, University of California-Davis, Sacramento, CA, USA.
  • Wunder JS; Division of Orthopaedic Surgery, University Musculoskeletal Oncology Unit, Mount Sinai Hospital, Toronto, Ontario, Canada.
  • Ferguson PC; Division of Orthopaedic Surgery, University Musculoskeletal Oncology Unit, Mount Sinai Hospital, Toronto, Ontario, Canada.
  • Verspoor FGM; Department of Orthopedic Surgery, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
  • Houdek MT; Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN, USA.
  • Bernthal NM; Department of Orthopaedic Surgery, University of California-Los Angeles, Los Angeles, CA, USA.
  • Schreuder BHWB; Department of Orthopaedics, Radboudumc, Nijmegen, the Netherlands.
  • Gelderblom H; Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands.
  • van de Sande MAJ; Department of Orthopedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.
  • van der Heijden L; Department of Orthopedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.
Eur J Surg Oncol ; 50(2): 107953, 2024 Feb.
Article en En | MEDLINE | ID: mdl-38215550
ABSTRACT

BACKGROUND:

Diffuse-type tenosynovial giant cell tumor (D-TGCT) is a mono-articular, soft-tissue tumor. Although it can behave locally aggressively, D-TGCT is a non-malignant disease. This is the first study describing the natural course of D-TGCT and evaluating active surveillance as possible treatment strategy.

METHODS:

This retrospective, multicenter study included therapy naïve patients with D-TGCT from eight sarcoma centers worldwide between 2000 and 2019. Patients initially managed by active surveillance following their first consultation were eligible. Data regarding the radiological and clinical course and subsequent treatments were collected.

RESULTS:

Sixty-one patients with primary D-TGCT were initially managed by active surveillance. Fifty-nine patients had an MRI performed around first consultation D-TGCT was located intra-articular in most patients (n = 56; 95 %) and extra-articular in 14 cases (24 %). At baseline, osteoarthritis was observed in 13 patients (22 %) on MRI. Most of the patients' reported symptoms pain (n = 43; 70 %), swelling (n = 33; 54 %). Eight patients (13 %) were asymptomatic. Follow-up data were available for 58 patients; the median follow-up was 28 months. Twenty-one patients (36 %) had radiological progression after 21 months (median). Eight of 45 patients (18 %) without osteoarthritis at baseline developed osteoarthritis during follow-up. Thirty-seven patients (64 %) did not clinically deteriorate during follow-up. Finally, eighteen patients (31 %) required a subsequent treatment.

CONCLUSION:

Active surveillance can be considered adequate for selected therapy naïve D-TGCT patients. Although follow-up data was limited, almost two-thirds of the patients remained progression-free, and 69 % did not need treatment during the follow-up period. However, one-fifth of patients developed secondary osteoarthritis. Prospective studies on active surveillance are warranted.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Osteoartritis / Neoplasias de los Tejidos Blandos / Sinovitis Pigmentada Vellonodular / Tumor de Células Gigantes de las Vainas Tendinosas Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Screening_studies Límite: Humans Idioma: En Revista: Eur J Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Osteoartritis / Neoplasias de los Tejidos Blandos / Sinovitis Pigmentada Vellonodular / Tumor de Células Gigantes de las Vainas Tendinosas Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Screening_studies Límite: Humans Idioma: En Revista: Eur J Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido