Verspoor Floortje G M, Zee Aniek A G, Hannink Gerjon, van der Geest Ingrid C M, Veth Rene P H, Schreuder H W Bart
Department of Orthopedics, Radboud University Medical Center, Nijmegen, The Netherlands.
Rheumatology (Oxford). 2014 Nov;53(11):2063-70. doi: 10.1093/rheumatology/keu230. Epub 2014 Jun 10.
Adequate documentation of the outcome of treatment of pigmented villonodular synovitis (PVNS) is sparse. Available case series show relatively short follow-up times and often combine locations or subtypes to increase patient numbers. This article describes the long-term follow-up of a single institution's large consecutive series of PVNS.
Retrospectively, 107 PVNS patients were identified between 1985 and 2011 by searching pathology and radiology records. Treatment complications, recurrences and quality of life were evaluated. Most patients (85.2%) were primarily or secondarily treated at our institution.
Both subtypes, localized PVNS [29 (27%)] and diffuse PVNS [75 (70%)] were represented. The knee was affected in 88% of patients. Treatments received were surgery, external beam radiotherapy, radiosynovectomy, targeted therapy, immunotherapy or combinations of these. Forty-nine (46%) patients had prior treatment elsewhere. The mean follow-up from diagnosis until last contact was 7.0 years (range 0.3-27.4) for localized PVNS and 14.5 years (range 1.1-48.7) for diffuse PVNS. The 1- and 5-year recurrence-free survival rates for diffuse PVNS were 69% and 32%, respectively. Quality of life, estimated by 36-item Short Form Health Survey (SF-36) scores, were not significantly different between localized and diffuse PVNS. However, both patient groups scored lower than the general population norms on the general health component (59.2 and 56.3, respectively, P < 0.05).
Recurrence rates of PVNS increase with time. Long-term follow-up shows, particularly in diffuse PVNS, it is a continually recurring problem, and over time it becomes increasingly difficult to cure. The quality of life is decreased in patients with PVNS compared with the general population.
关于色素沉着绒毛结节性滑膜炎（PVNS）治疗结果的充分文献记载较为匮乏。现有的病例系列研究显示随访时间相对较短，并且常常将不同部位或亚型合并以增加患者数量。本文描述了单一机构中大量连续性PVNS病例的长期随访情况。
通过检索病理和放射学记录，回顾性地确定了1985年至2011年间的107例PVNS患者。对治疗并发症、复发情况及生活质量进行了评估。大多数患者（85.2%）在本机构接受了初次或二次治疗。
包括局限性PVNS[29例（27%）]和弥漫性PVNS[75例（70%）]两种亚型。88%的患者膝关节受累。接受的治疗包括手术、体外放射治疗、放射性滑膜切除、靶向治疗、免疫治疗或这些治疗的联合应用。49例（46%）患者曾在其他地方接受过治疗。局限性PVNS从诊断至最后一次联系的平均随访时间为7.0年（范围0.3 - 27.4年），弥漫性PVNS为14.5年（范围1.1 - 48.7年）。弥漫性PVNS的1年和5年无复发生存率分别为69%和32%。通过36项简明健康调查（SF - 36）评分评估的生活质量，局限性和弥漫性PVNS之间无显著差异。然而，两组患者在总体健康分量表上的得分均低于一般人群标准（分别为59.2和56.3，P < 0.05）。
PVNS的复发率随时间增加。长期随访显示，尤其是弥漫性PVNS，这是一个持续复发的问题，且随着时间推移治愈变得越来越困难。与一般人群相比，PVNS患者的生活质量有所下降。
