Treatment, recurrence rates and follow-up of Tenosynovial Giant Cell Tumor (TGCT) of the foot and ankle-A systematic review and meta-analysis
The tenosynovial giant cell tumor (TGCT) is a usually benign lesion which arises from the synovium. It affects joints, tendon sheaths and bursae. The clinical course is often unpredictable, and local recurrences frequently occur. The aim of this study was to describe different treatment options, sur...
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description | The tenosynovial giant cell tumor (TGCT) is a usually benign lesion which arises from the synovium. It affects joints, tendon sheaths and bursae. The clinical course is often unpredictable, and local recurrences frequently occur. The aim of this study was to describe different treatment options, surgical complications, and to develop a follow-up regime based on a systematic literature review and meta-analysis of foot and ankle lesions.
1284 studies published between 01/1966 and 06/2021 were identified. 25 met the inclusion criteria, with a total of 382 patients. Of these, 212 patients had a diffuse (dTGCT) and 170 a localized (lTGCT) TGCT. Patients with a dTGCT had a mean age of 36.6±8.2 years, and 55% were female. The overall complication rate was 24% in dTGCT, irrespective of the therapeutic procedure; the mean follow-up was 37.9±27.4 months with a recurrence rate of 21%, and recurrences occurred between 3 and 144 months, the vast majority (86%) within the first 5 years following intervention. Patients with a lTGCT had a mean age of 31.2±5.7 years, and 53% were female. Complications occurred in 12%. The mean follow-up was 51.1±24.6 months, the recurrence rate was 7%, and recurrence occurred between 1 and 244 months after intervention.
Diffuse TGCTs of the foot and ankle region have a remarkable recurrence rate irrespective of therapeutic procedures, and most lesions reoccurred within 5, with more than half of these in the first 2 years. The lTGCTs are well treatable lesions, with a low recurrence and a moderate complication rate. Based on these findings, we propose a follow-up regime for the dTGCT including a clinical survey and MR imaging 3 months after surgical intervention (baseline), followed by twice-yearly intervals for the first 2 years, yearly intervals up to the fifth year, and further individual follow-up due to the fact that recurrences can even occur for years later. For the lTGCT a clinical survey and MRT is proposed after 3-6 months after intervention (baseline), followed by annual clinical examination for 3 years, and in case of symptoms MR-imaging. Larger prospective multi-center studies are necessary to confirm these results and recommendations. |
doi_str_mv | 10.1371/journal.pone.0260795 |
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1284 studies published between 01/1966 and 06/2021 were identified. 25 met the inclusion criteria, with a total of 382 patients. Of these, 212 patients had a diffuse (dTGCT) and 170 a localized (lTGCT) TGCT. Patients with a dTGCT had a mean age of 36.6±8.2 years, and 55% were female. The overall complication rate was 24% in dTGCT, irrespective of the therapeutic procedure; the mean follow-up was 37.9±27.4 months with a recurrence rate of 21%, and recurrences occurred between 3 and 144 months, the vast majority (86%) within the first 5 years following intervention. Patients with a lTGCT had a mean age of 31.2±5.7 years, and 53% were female. Complications occurred in 12%. The mean follow-up was 51.1±24.6 months, the recurrence rate was 7%, and recurrence occurred between 1 and 244 months after intervention.
Diffuse TGCTs of the foot and ankle region have a remarkable recurrence rate irrespective of therapeutic procedures, and most lesions reoccurred within 5, with more than half of these in the first 2 years. The lTGCTs are well treatable lesions, with a low recurrence and a moderate complication rate. Based on these findings, we propose a follow-up regime for the dTGCT including a clinical survey and MR imaging 3 months after surgical intervention (baseline), followed by twice-yearly intervals for the first 2 years, yearly intervals up to the fifth year, and further individual follow-up due to the fact that recurrences can even occur for years later. For the lTGCT a clinical survey and MRT is proposed after 3-6 months after intervention (baseline), followed by annual clinical examination for 3 years, and in case of symptoms MR-imaging. Larger prospective multi-center studies are necessary to confirm these results and recommendations.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0260795</identifier><identifier>PMID: 34855875</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Ankle ; Ankle - pathology ; Ankle - surgery ; Biology and Life Sciences ; Care and treatment ; Complications ; Diagnosis ; Diseases ; Evidence-based medicine ; Feet ; Females ; Follow-Up Studies ; Foot diseases ; Foot Diseases - pathology ; Foot Diseases - surgery ; Giant Cell Tumor of Tendon Sheath - pathology ; Giant Cell Tumor of Tendon Sheath - surgery ; Humans ; Intervals ; Lesions ; Literature reviews ; Localization ; Magnetic resonance imaging ; Medicine ; Medicine and Health Sciences ; Meta-analysis ; Neoplasm Recurrence, Local - etiology ; Neoplasm Recurrence, Local - pathology ; Orthopedics ; Patients ; Physical Sciences ; Polls & surveys ; Postoperative Complications - etiology ; Postoperative Complications - pathology ; Radiation therapy ; Relapse ; Research and Analysis Methods ; Sheaths ; Surgery ; Surgical Procedures, Operative - adverse effects ; Surgical techniques ; Synovium ; Systematic review ; Tumors</subject><ispartof>PloS one, 2021-12, Vol.16 (12), p.e0260795-e0260795</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Siegel et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Siegel et al 2021 Siegel et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c659t-8c15cad846136a8d5a686cf155bb4d537ec268b651fd74ea06a6e532396df5d83</citedby><cites>FETCH-LOGICAL-c659t-8c15cad846136a8d5a686cf155bb4d537ec268b651fd74ea06a6e532396df5d83</cites><orcidid>0000-0002-9466-2157 ; 0000-0001-8755-6383</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8638888/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8638888/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34855875$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Takeuchi, Akihiko</contributor><creatorcontrib>Siegel, M</creatorcontrib><creatorcontrib>Bode, L</creatorcontrib><creatorcontrib>Südkamp, N</creatorcontrib><creatorcontrib>Kühle, J</creatorcontrib><creatorcontrib>Zwingmann, J</creatorcontrib><creatorcontrib>Schmal, H</creatorcontrib><creatorcontrib>Herget, G W</creatorcontrib><title>Treatment, recurrence rates and follow-up of Tenosynovial Giant Cell Tumor (TGCT) of the foot and ankle-A systematic review and meta-analysis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The tenosynovial giant cell tumor (TGCT) is a usually benign lesion which arises from the synovium. It affects joints, tendon sheaths and bursae. The clinical course is often unpredictable, and local recurrences frequently occur. The aim of this study was to describe different treatment options, surgical complications, and to develop a follow-up regime based on a systematic literature review and meta-analysis of foot and ankle lesions.
1284 studies published between 01/1966 and 06/2021 were identified. 25 met the inclusion criteria, with a total of 382 patients. Of these, 212 patients had a diffuse (dTGCT) and 170 a localized (lTGCT) TGCT. Patients with a dTGCT had a mean age of 36.6±8.2 years, and 55% were female. The overall complication rate was 24% in dTGCT, irrespective of the therapeutic procedure; the mean follow-up was 37.9±27.4 months with a recurrence rate of 21%, and recurrences occurred between 3 and 144 months, the vast majority (86%) within the first 5 years following intervention. Patients with a lTGCT had a mean age of 31.2±5.7 years, and 53% were female. Complications occurred in 12%. The mean follow-up was 51.1±24.6 months, the recurrence rate was 7%, and recurrence occurred between 1 and 244 months after intervention.
Diffuse TGCTs of the foot and ankle region have a remarkable recurrence rate irrespective of therapeutic procedures, and most lesions reoccurred within 5, with more than half of these in the first 2 years. The lTGCTs are well treatable lesions, with a low recurrence and a moderate complication rate. Based on these findings, we propose a follow-up regime for the dTGCT including a clinical survey and MR imaging 3 months after surgical intervention (baseline), followed by twice-yearly intervals for the first 2 years, yearly intervals up to the fifth year, and further individual follow-up due to the fact that recurrences can even occur for years later. For the lTGCT a clinical survey and MRT is proposed after 3-6 months after intervention (baseline), followed by annual clinical examination for 3 years, and in case of symptoms MR-imaging. Larger prospective multi-center studies are necessary to confirm these results and recommendations.</description><subject>Ankle</subject><subject>Ankle - pathology</subject><subject>Ankle - surgery</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Complications</subject><subject>Diagnosis</subject><subject>Diseases</subject><subject>Evidence-based medicine</subject><subject>Feet</subject><subject>Females</subject><subject>Follow-Up Studies</subject><subject>Foot diseases</subject><subject>Foot Diseases - pathology</subject><subject>Foot Diseases - surgery</subject><subject>Giant Cell Tumor of Tendon Sheath - pathology</subject><subject>Giant Cell Tumor of Tendon Sheath - surgery</subject><subject>Humans</subject><subject>Intervals</subject><subject>Lesions</subject><subject>Literature reviews</subject><subject>Localization</subject><subject>Magnetic resonance imaging</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Meta-analysis</subject><subject>Neoplasm Recurrence, Local - 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pathology</topic><topic>Ankle - surgery</topic><topic>Biology and Life Sciences</topic><topic>Care and treatment</topic><topic>Complications</topic><topic>Diagnosis</topic><topic>Diseases</topic><topic>Evidence-based medicine</topic><topic>Feet</topic><topic>Females</topic><topic>Follow-Up Studies</topic><topic>Foot diseases</topic><topic>Foot Diseases - pathology</topic><topic>Foot Diseases - surgery</topic><topic>Giant Cell Tumor of Tendon Sheath - pathology</topic><topic>Giant Cell Tumor of Tendon Sheath - surgery</topic><topic>Humans</topic><topic>Intervals</topic><topic>Lesions</topic><topic>Literature reviews</topic><topic>Localization</topic><topic>Magnetic resonance imaging</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Meta-analysis</topic><topic>Neoplasm Recurrence, Local - etiology</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Orthopedics</topic><topic>Patients</topic><topic>Physical Sciences</topic><topic>Polls & surveys</topic><topic>Postoperative Complications - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Siegel, M</au><au>Bode, L</au><au>Südkamp, N</au><au>Kühle, J</au><au>Zwingmann, J</au><au>Schmal, H</au><au>Herget, G W</au><au>Takeuchi, Akihiko</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment, recurrence rates and follow-up of Tenosynovial Giant Cell Tumor (TGCT) of the foot and ankle-A systematic review and meta-analysis</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-12-02</date><risdate>2021</risdate><volume>16</volume><issue>12</issue><spage>e0260795</spage><epage>e0260795</epage><pages>e0260795-e0260795</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The tenosynovial giant cell tumor (TGCT) is a usually benign lesion which arises from the synovium. It affects joints, tendon sheaths and bursae. The clinical course is often unpredictable, and local recurrences frequently occur. The aim of this study was to describe different treatment options, surgical complications, and to develop a follow-up regime based on a systematic literature review and meta-analysis of foot and ankle lesions.
1284 studies published between 01/1966 and 06/2021 were identified. 25 met the inclusion criteria, with a total of 382 patients. Of these, 212 patients had a diffuse (dTGCT) and 170 a localized (lTGCT) TGCT. Patients with a dTGCT had a mean age of 36.6±8.2 years, and 55% were female. The overall complication rate was 24% in dTGCT, irrespective of the therapeutic procedure; the mean follow-up was 37.9±27.4 months with a recurrence rate of 21%, and recurrences occurred between 3 and 144 months, the vast majority (86%) within the first 5 years following intervention. Patients with a lTGCT had a mean age of 31.2±5.7 years, and 53% were female. Complications occurred in 12%. The mean follow-up was 51.1±24.6 months, the recurrence rate was 7%, and recurrence occurred between 1 and 244 months after intervention.
Diffuse TGCTs of the foot and ankle region have a remarkable recurrence rate irrespective of therapeutic procedures, and most lesions reoccurred within 5, with more than half of these in the first 2 years. The lTGCTs are well treatable lesions, with a low recurrence and a moderate complication rate. Based on these findings, we propose a follow-up regime for the dTGCT including a clinical survey and MR imaging 3 months after surgical intervention (baseline), followed by twice-yearly intervals for the first 2 years, yearly intervals up to the fifth year, and further individual follow-up due to the fact that recurrences can even occur for years later. For the lTGCT a clinical survey and MRT is proposed after 3-6 months after intervention (baseline), followed by annual clinical examination for 3 years, and in case of symptoms MR-imaging. Larger prospective multi-center studies are necessary to confirm these results and recommendations.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>34855875</pmid><doi>10.1371/journal.pone.0260795</doi><orcidid>https://orcid.org/0000-0002-9466-2157</orcidid><orcidid>https://orcid.org/0000-0001-8755-6383</orcidid><oa>free_for_read</oa></addata></record> |
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ispartof | PloS one, 2021-12, Vol.16 (12), p.e0260795-e0260795 |
issn | 1932-6203 1932-6203 |
language | eng |
recordid | cdi_plos_journals_2605598831 |
source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS) Journals Open Access; PubMed Central; Free Full-Text Journals in Chemistry |
subjects | Ankle Ankle - pathology Ankle - surgery Biology and Life Sciences Care and treatment Complications Diagnosis Diseases Evidence-based medicine Feet Females Follow-Up Studies Foot diseases Foot Diseases - pathology Foot Diseases - surgery Giant Cell Tumor of Tendon Sheath - pathology Giant Cell Tumor of Tendon Sheath - surgery Humans Intervals Lesions Literature reviews Localization Magnetic resonance imaging Medicine Medicine and Health Sciences Meta-analysis Neoplasm Recurrence, Local - etiology Neoplasm Recurrence, Local - pathology Orthopedics Patients Physical Sciences Polls & surveys Postoperative Complications - etiology Postoperative Complications - pathology Radiation therapy Relapse Research and Analysis Methods Sheaths Surgery Surgical Procedures, Operative - adverse effects Surgical techniques Synovium Systematic review Tumors |
title | Treatment, recurrence rates and follow-up of Tenosynovial Giant Cell Tumor (TGCT) of the foot and ankle-A systematic review and meta-analysis |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-02T22%3A41%3A08IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Treatment,%20recurrence%20rates%20and%20follow-up%20of%20Tenosynovial%20Giant%20Cell%20Tumor%20(TGCT)%20of%20the%20foot%20and%20ankle-A%20systematic%20review%20and%20meta-analysis&rft.jtitle=PloS%20one&rft.au=Siegel,%20M&rft.date=2021-12-02&rft.volume=16&rft.issue=12&rft.spage=e0260795&rft.epage=e0260795&rft.pages=e0260795-e0260795&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0260795&rft_dat=%3Cgale_plos_%3EA684621179%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2605598831&rft_id=info:pmid/34855875&rft_galeid=A684621179&rft_doaj_id=oai_doaj_org_article_4ba64c3079f34c0587b3533bd81a2999&rfr_iscdi=true |