Some patients with tenosynovial giant cell tumour (TGCT) may not be surgical candidates for several reasons:1,2
complexity3 e.g., nerve
entrapment or complex
multifocal TGCT2
fear of surgery6
might exacerbate
symptoms or cause
permanent joint damage7
Treatment decisions should always consider the long-term impact on a patient’s daily functioning, wellbeing and personal goals;3 shared-decision making is key to ensure patients are empowered in their care choices.8
Referral to specialized sarcoma centers is critical to ensure patients receive timely access to appropriate treatment and dedicated specialists.3,9,10
NON-SURGICAL ALTERNATIVES
The availability of non-surgical options for TGCT may differ, depending on the local availability of alternative treatments.3
Chemotherapy
Conventional chemotherapy is not indicated in TGCT3
Radiotherapy or cryotherapy
There is insufficient data to support the use of radiation or cryotherapy to treat TGCT3
SYSTEMIC TREATMENT
The systemic treatment landscape for TGCT is rapidly evolving, however the availability of these therapies may differ across countries2,3
Managing patients with TGCT who are not eligible for surgery can be challenging, especially in countries where the availability of alternative options may be limited.2,3
TREATMENT FOR PATIENTS WITH ASYMPTOMATIC TGCT
Active surveillance (AS) is the preferred initial approach for asymptomatic TGCT. In some cases, it can also be considered for symptomatic patients at risk of major complications from treatment.3
However, long-term follow up on AS is limited, so the impact of AS on long-term joint health in TGCT is not known.11 If left untreated, TGCT may result in progressive joint deterioration.12
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