Division of Musculoskeletal Oncology, David Geffen School of Medicine at UCLA, Santa Monica, California, USA.
Department of Surgery, Orthopaedic Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
J Surg Oncol. 2022 Dec;126(8):1520-1532. doi: 10.1002/jso.27067. Epub 2022 Aug 25.
Diffuse-tenosynovial giant cell tumor (D-TGCT) is a rare, locally aggressive, typically benign neoplasm affecting mainly large joints, representing a wide clinical spectrum. We provide a picture of the treatment journey of D-TGCT patients as a 2-year observational follow-up.
The TGCT Observational Platform Project registry was a multinational, multicenter, prospective observational study at tertiary sarcoma centers spanning seven European countries and two US sites. Histologically confirmed D-TGCT patients were categorized as either those who remained on initial treatment strategy (determined at baseline visit) or those who changed treatment strategy with specific changes documented (e.g., systemic treatment to surgery) at the 1-year and/or 2-year follow-up visits.
A total of 176 patients were assessed, mean diagnosis age was 38.4 (SD ± 14.6) years; most patients had a knee tumor (120/176, 68.2%). For the 2-year observation period, most patients (75.5%) remained on the baseline treatment strategy throughout, 54/79 patients (68.4%) remained no treatment, 30/45 patients (66.7%) remained systemic treatment, 39/39 patients (100%) remained surgery. Those who changed treatment strategy utilized multimodal treatment options.
This is the first prospectively collected analysis to describe D-TGCT patient treatments over an extended follow-up and demonstrates the need for multidisciplinary teams to determine an optimal treatment strategy.
弥漫性腱鞘巨细胞瘤(D-TGCT)是一种罕见的、局部侵袭性、通常为良性的肿瘤,主要影响大关节,具有广泛的临床谱。我们提供了一个 D-TGCT 患者治疗过程的图片,作为 2 年的观察随访。
TGCT 观察平台项目登记处是一个多中心、前瞻性观察研究,在七个欧洲国家和两个美国地点的三级肉瘤中心进行。组织学确诊的 D-TGCT 患者分为两种:一种是仍在初始治疗策略上(在基线就诊时确定),另一种是在 1 年和/或 2 年的随访中记录了具体治疗策略变化的患者(例如,从系统治疗转为手术)。
共评估了 176 例患者,平均诊断年龄为 38.4(标准差±14.6)岁;大多数患者有膝关节肿瘤(120/176,68.2%)。在 2 年的观察期内,大多数患者(75.5%)始终坚持基线治疗策略,79 例患者中的 54 例(68.4%)未接受治疗,45 例患者中的 30 例(66.7%)仍接受系统治疗,39 例患者中的 39 例(100%)仍接受手术。改变治疗策略的患者采用了多模式治疗方案。
这是首次前瞻性收集分析描述 D-TGCT 患者在延长随访期间的治疗情况,并证明需要多学科团队来确定最佳治疗策略。