• Emanuela Palmerini, Eric L Staals, Robert G Maki, Stefano Pengo, Angela Cioffi, Marco Gambarotti, Piero Picci, Primo Andrea Daolio, Antonina Parafioriti, Carol Morris, Cristina R Antonescu, Alessandro Gronchi, Paolo Giovanni Casali, Davide M Donati, Stefano Ferrari, and Silvia Stacchiotti.
• Chemotherapy, Musculoskeletal Oncology Department, Istituto Ortopedico Rizzoli, Bologna, Italy.
• Eur. J. Cancer. 2015 Jan 1; 51 (2): 210-7.

BackgroundTenosynovial 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.MethodsPatients 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.Results294 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.ConclusionsThis 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.Copyright © 2014 Elsevier Ltd. All rights reserved.

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