Best clinical management of tenosynovial giant cell tumour (TGCT): A consensus paper from the community of experts
Silvia Stacchiotti, Hans Roland Dürr, Inga‐Marie Schaefer, Klaus Woertler, Rick L. Haas, Annalisa Trama, Augusto Caraceni, Jyoti Bajpai, Giacomo Giulio Baldi, Nicholas M. Bernthal, Jean‐Yves Blay, Kjetil Boye, Javier Martín‐Broto, Wei-Wu Tom Chen, Angelo Paolo Dei Tos, Jayesh Desai, Stephan Emhofer, Mikael Eriksson, Alessandro Gronchi, Hans Gelderblom, Jendrik Hardes, Wolfgang Hartmann, John H. Healey, Antoîne Italiano, Robin L. Jones, Akira Kawai, Andreas Leithner, Herbert H. Loong, Éric Mascard, Carlo Morosi, Nadine Otten, Emanuela Palmerini, Shreyaskumar Patel, Peter Reichardt, Brian P. Rubin, Piotr Rutkowski, Claudia Sangalli, Kathrin Schuster, Beatrice Seddon, Morena Shkcodra, Eric L. Staals, William D. Tap, Matt van de Rijn, Kirsten van Langevelde, Filip M.M. Vanhoenacker, Andrew J. Wagner, Lisette M. Wiltink, Sydney Stern, Michiel A. J. van de Sande, Sebastian Bauer
Abstract
Tenosynovial giant cell tumour (TGCT) is a rare, locally aggressive, mesenchymal tumor arising from the joints, bursa and tendon sheaths. TGCT comprises a nodular- and a diffuse-type, with the former exhibiting mostly indolent course and the latter a locally aggressive behavior. Although usually not life-threatening, TGCT may cause chronic pain and adversely impact function and quality of life (QoL). CSFR1 inhibitors are effective with benefit on symptoms and QoL but are not available in most countries. The degree of uncertainty in selecting the most appropriate therapy and the lack of guidelines on the clinical management of TGCT make the adoption of new treatments inconsistent across the world, with suboptimal outcomes for patients. A global consensus meeting was organized in June 2022, involving experts from several disciplines and patient representatives from SPAGN to define the best evidence-based practice for the optimal approach to TGCT and generate the recommendations presented herein.