Surgical Treatment of Localized-Type Tenosynovial Giant Cell Tumors of Large Joints
| Autor: | Mastboom, M.J.L., Staals, E.L., Verspoor, F.G.M., Rueten-Budde, A.J., Stacchiotti, S., Palmerini, E., Schaap, G.R., Jutte, P.C., Aston, W., Leithner, A., Dammerer, D., Takeuchi, A., Thio, Q., Niu, X., Wunder, J.S., Sande, M.A.J. van de, Fiocco, M., Dijkstra, P.D.S., Wal, R.J.P. van der, Daolio, P.A., Picci, P., Gronchi, A., Ferrari, S., Ozger, H., Maki, R.G., Schreuder, H.W.B., Geest, I.C.M. van der, Bramer, J.A.M., Mastboom, W.J.B., Boffano, M., Goldenitsch, E., Companacci, D., Cuomo, P., Ferguson, P.C., Griffin, A.M., Sun, Y., Schubert, T., Patel, K., Aranguren, M.S.J., Blancheton, A., Gouin, F., Durr, H.R., Capellen, C.F., Schwab, J., Iwata, S., Vyrva, O., Weschenfelder, W., Wang, E.H.M., Joo, M.W., Kang, Y.K., Chung, Y.G., Ebeid, W., Bruns, J., Ueda, T., TGCT Study Grp |
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| Rok vydání: | 2019 |
| Předmět: | |
| Zdroj: | Journal of Bone and Joint Surgery. American Volume, 101, 1309-1318 Journal of Bone and Joint Surgery. American Volume, 101, 14, pp. 1309-1318 Journal of Bone and Joint Surgery, 101(14), 1309-1318 |
| ISSN: | 0021-9355 |
| Popis: | Contains fulltext : 208133.pdf (Publisher’s version ) (Closed access) 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 undergone therapy previously yielded positive associations between local recurrence and a tumor size of >= 5 cm versus |
| Databáze: | OpenAIRE |
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