医学
无症状的
骨关节炎
回顾性队列研究
放射性武器
队列
外科
内科学
病理
替代医学
作者
Geert Spierenburg,Eric L. Staals,Emanuela Palmerini,R. Lor Randall,Steven W. Thorpe,Jay S. Wunder,Peter C. Ferguson,F.G.M. Verspoor,Matthew T. Houdek,Nicholas M. Bernthal,Bart Schreuder,Hans Gelderblom,Michiel A. J. van de Sande,L. van der Heijden
出处
期刊:Ejso
[Elsevier]
日期:2024-01-06
卷期号:50 (2): 107953-107953
被引量:1
标识
DOI:10.1016/j.ejso.2024.107953
摘要
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 2000-2019. 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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