Surgical Treatment of Localized-Type Tenosynovial Giant Cell Tumors of Large Joints

Abstract

Background: Localized-type tenosynovial giant cell tumor (TGCT) is a rare, neoplastic disease with only limited data supporting treatment protocols. We describe treatment protocols and evaluate their oncological outcome, complications, and functional results in a large multicenter cohort of patients. A secondary study aim was to identify factors associated with local recurrence after surgical treatment.Methods: Patients with histologically proven localized TGCT of a large joint were included if they had been treated between 1990 and 2017 in 1 of 31 tertiary sarcoma centers. Of 941 patients with localized TGCT, 62% were female. The median age at initial treatment was 39 years, and the median duration of follow-up was 34 months. Sixty-seven percent of the tumors affected the knee, and the primary treatment at the tertiary center was 1-stage open resection in 73% of the patients. Proposed factors for predicting a first local recurrence after treatment in the tertiary center were tested in a univariate analysis, and those that demonstrated significance were subsequently included in a multivariate analysis. Results:The localized TGCT recurred in 12% of all cases, with local-recurrence-free rates at 3, 5, and 10 years of 88%, 83%, and 79%, respectively. The strongest factor for predicting recurrent disease was a prior recurrence (p < 0.001). Surgical treatment decreased pain and swelling in 71% and 85% of the patients, respectively, and such treatment was associated with complications in 4% of the patients. Univariate and multivariate analyses of the patients who had not continued *In addition to the listed authors, members of the Tenosynovial Giant Cell Tumors (TGCT) Study Group include M.

Best clinical management of tenosynovial giant cell tumour (TGCT): A consensus paper from the community of experts

“…Contamination of the joint in intralesional resections is rarely reported, but a large multicenter study of N-TGCT showed a lower LRR after open versus arthroscopic surgery (13 % versus 20 %). [47] In the posterior compartment, open resection is preferred [IV, B].…”

Localized tenosynovial gigantocellular tumor of the ankle in an adolescent: case report and literature review

“…lokalizirani TGCT ( u daljnjem tekstu LTGCT) ili zahvaćati čitav zglob, tzv. difuzni TGCT, pri čemu je histološka slika kod oba oblika jednaka (1)(2)(3)(4). Točna etiologija bolesti je nepoznata.…”

“…Točna etiologija bolesti je nepoznata. No, zbog prisutnosti kromosomske translokacije t(1;2) (CSF-1;COL6A3) u mononuklearnim stanicama, moguće je i klonalno neoplastično podrijetlo (2)(3)(4). Stopa pojavnosti TGCT-a u ukupnoj populaciji iznosi deset slučajeva na milijun ljudi za lokalizirani, odnosno četiri slučaja na milijun ljudi za difuzni oblik bolesti (2).…”

“…U gležnju se TGCT znatno rjeđe pojavljuje pa tako lokalizirani oblik čini 5%, a difuzni 10% svih slučajeva TGCT-a 2 . TGCT se u gležnju obično javlja između 30-te i 40-te godine života neovisno o spolu (2,3). Cilj ovog rada je prikazati rijedak slučaj lokaliziranog oblika TGCT-a u prednjem dijelu gležnja u adolescentice.…”

Surgical treatment of spinal tenosynovial giant cell tumor: Experience from a single center and literature review

“…However, TGCT has shown a propensity for local recurrence after surgical resection, especially diffuse TGCT, with a local recurrence rate of up to 10–48% in previous studies ( 4 – 8 ). Therefore, gross total resection (GTR) with postoperative radiotherapy has been recommended for TGCT to reduce local recurrence ( 9 ). Due to the special anatomy and functions of the spine, the clinical characteristics, treatment method, and prognosis of spinal TGCT might be different from those of TGCT of the extremities.…”