TY - JOUR
T1 - One-Stage Synovectomies Result in Improved Short-Term Outcomes Compared to Two-Stage Synovectomies of Diffuse-Type Tenosynovial Giant Cell Tumor (D-TGCT) of the Knee
T2 - A Multicenter, Retrospective, Cohort Study
AU - Spierenburg, Geert
AU - Verspoor, Floortje G. M.
AU - Wunder, Jay S.
AU - Griffin, Anthony M.
AU - Ferguson, Peter C.
AU - Houdek, Matthew T.
AU - King, David M.
AU - Boyle, Richard
AU - Lor Randall, Robert
AU - Thorpe, Steven W.
AU - Priester, Jacob I.
AU - Geiger, Erik J.
AU - van der Heijden, Lizz
AU - Bernthal, Nicholas M.
AU - Schreuder, Bart H. W. B.
AU - Gelderblom, Hans
AU - van de Sande, Michiel A. J.
N1 - Funding Information: G.S. and M.A.J.v.d.S. report research funding from Daiichi-Sankyo to the department of Orthopedic Surgery of the Leiden University Medical Center outside the submitted work. F.G.M.V., J.S.W., A.M.G., P.C.F., M.T.H., D.M.K., R.B., R.L.R., S.W.T., J.I.P., E.J.G., L.v.d.H., N.M.B., B.H.W.B.S. and H.G. declare no conflict of interest. Publisher Copyright: © 2023 by the authors.
PY - 2023/2/1
Y1 - 2023/2/1
N2 - Diffuse-type tenosynovial giant cell tumors’ (D-TGCTs) intra- and extra-articular expansion about the knee often necessitates an anterior and posterior surgical approach to facilitate an extensive synovectomy. There is no consensus on whether two-sided synovectomies should be performed in one or two stages. This retrospective study included 191 D-TGCT patients from nine sarcoma centers worldwide to compare the postoperative short-term outcomes between both treatments. Secondary outcomes were rates of radiological progression and subsequent treatments. Between 2000 and 2020, 117 patients underwent one-stage and 74 patients underwent two-stage synovectomies. The maximum range of motion achieved within one year postoperatively was similar (flexion 123–120°, p = 0.109; extension 0°, p = 0.093). Patients undergoing two-stage synovectomies stayed longer in the hospital (6 vs. 4 days, p < 0.0001). Complications occurred more often after two-stage synovectomies, although this was not statistically different (36% vs. 24%, p = 0.095). Patients treated with two-stage synovectomies exhibited more radiological progression and required subsequent treatments more often than patients treated with one-stage synovectomies (52% vs. 37%, p = 0.036) (54% vs. 34%, p = 0.007). In conclusion, D-TGCT of the knee requiring two-side synovectomies should be treated by one-stage synovectomies if feasible, since patients achieve a similar range of motion, do not have more complications, but stay for a shorter time in the hospital.
AB - Diffuse-type tenosynovial giant cell tumors’ (D-TGCTs) intra- and extra-articular expansion about the knee often necessitates an anterior and posterior surgical approach to facilitate an extensive synovectomy. There is no consensus on whether two-sided synovectomies should be performed in one or two stages. This retrospective study included 191 D-TGCT patients from nine sarcoma centers worldwide to compare the postoperative short-term outcomes between both treatments. Secondary outcomes were rates of radiological progression and subsequent treatments. Between 2000 and 2020, 117 patients underwent one-stage and 74 patients underwent two-stage synovectomies. The maximum range of motion achieved within one year postoperatively was similar (flexion 123–120°, p = 0.109; extension 0°, p = 0.093). Patients undergoing two-stage synovectomies stayed longer in the hospital (6 vs. 4 days, p < 0.0001). Complications occurred more often after two-stage synovectomies, although this was not statistically different (36% vs. 24%, p = 0.095). Patients treated with two-stage synovectomies exhibited more radiological progression and required subsequent treatments more often than patients treated with one-stage synovectomies (52% vs. 37%, p = 0.036) (54% vs. 34%, p = 0.007). In conclusion, D-TGCT of the knee requiring two-side synovectomies should be treated by one-stage synovectomies if feasible, since patients achieve a similar range of motion, do not have more complications, but stay for a shorter time in the hospital.
KW - TGCT
KW - diffuse-type
KW - knee
KW - one-stage
KW - synovectomy
KW - tenosynovial giant cell tumor
KW - two-stage
UR - http://www.scopus.com/inward/record.url?scp=85147777979&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/cancers15030941
DO - https://doi.org/10.3390/cancers15030941
M3 - Article
C2 - 36765897
SN - 2072-6694
VL - 15
JO - Cancers
JF - Cancers
IS - 3
M1 - 941
ER -