Tenosynovial giant cell tumour/pigmented villonodular synovitis: outcome of 294 patients before the era of kinase inhibitors

Palmerini, E., Staals, E. L., Maki, R. G., Pengo, S., Cioffi, A., Gambarotti, M., Picci, P., Daolio, P. A., Parafioriti, A., Morris, C., Antonescu, C. R., Gronchi, A., Casali, P. G., Donati, D. M., Ferrari, S., Stacchiotti, S. (January 2015) Tenosynovial giant cell tumour/pigmented villonodular synovitis: outcome of 294 patients before the era of kinase inhibitors. Eur J Cancer, 51 (2). pp. 210-7. ISSN 1879-0852 (Electronic)0959-8049 (Linking)

URL: https://www.ncbi.nlm.nih.gov/pubmed/25465190
DOI: 10.1016/j.ejca.2014.11.001


BACKGROUND: Tenosynovial giant cell tumour/pigmented villonodular synovitis (TGCT/PVNS) is a benign neoplasm of synovium and tendon sheath. We conducted a retrospective pooled analysis in three major referral centers. METHODS: Patients treated between 1998 and 2008 were examined. Only patients presenting with primary disease or first relapse were included. 5-year local failure free survival (5-year-LFFS) was analysed. RESULTS: 294 patients were included: 254 with new diagnosis and 40 in 1st local recurrence (171 F/123 M; median age: 36 years; tumour size 2 cm in 27% of patients, >2 to 5 cm in 41%, and >5 cm in 32%). A diffuse pattern was reported in 69%, localised in 31%. No metastases were documented. Local failure (LF) was reported in 28% of patients: 36% in diffuse pattern, 14% in localised (p = 0.002); median time to LF: 16 months. With a median follow-up of 4.4 years, 5-year-LFFS was 66%, with multiple (up to five) local recurrences in 40% of relapsed patients. Size <2 cm, macroscopically complete resection, female gender and new diagnosis were associated with a better local control. After multivariate analysis, a previous relapse was independently associated with local failure. CONCLUSIONS: This study underlines the propensity of TGCT/PVNS to multiple local recurrences. In absence of clinical factors, biological studies are needed to identify prognostic factors of local failure. After a first local recurrence, surgery does not seem to have a curative potential. In these high risk patients, studies addressing the role of target therapies are needed.

Item Type: Paper
Uncontrolled Keywords: Adolescent Adult Aged Disease-Free Survival Female Follow-Up Studies Giant Cell Tumors/*pathology/surgery Humans Male Middle Aged Multivariate Analysis Neoplasm Recurrence, Local Outcome Assessment (Health Care)/methods/statistics & numerical data Prognosis Retrospective Studies Synovial Membrane/*pathology/surgery Synovitis, Pigmented Villonodular/*pathology/surgery Tendons/*pathology/surgery Time Factors Young Adult Pigmented villonodular synovitis Prognostic factors Tenosynovial giant cell tumour Treatment Tyrosine kinase inhibitors
Subjects: diseases & disorders > cancer
bioinformatics > genomics and proteomics > genetics & nucleic acid processing > protein structure, function, modification > protein types > enzymes > kinase > tyrosine kinase
CSHL Authors:
Communities: CSHL labs > Maki lab
Depositing User: Matt Covey
Date: January 2015
Date Deposited: 20 Oct 2016 14:05
Last Modified: 20 Oct 2016 14:05
Related URLs:
URI: https://repository.cshl.edu/id/eprint/33769

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