Surgery is the standard of care for symptomatic tenosynovial giant cell tumor (TGCT) when it can be accomplished without significant morbidity.1
Typically, arthroscopic synovectomy is used for resection of nodular-type TGCT (N-TGCT) while open synovectomy is common for diffuse-type TGCT (D-TGCT), however there is no clear consensus on the type of procedure.2 The preferred approach is resection when macroscopically complete resection is achievable, and it can be accomplished without significant morbidity for durable local control and improved QoL. The indication and expected outcome of surgery should be discussed with the multidisciplinary tumor board and patient.1
The likelihood of successful surgery is dependent on many factors, including location and subtype.1,3 N-TGCT can be managed by complete marginal resection, with low LRR. Surgery for D-TGCT is associated with high LR risk and postoperative complications. All cases should be discussed by the multidisciplinary tumor board.1
SURGERY FOR TGCT is not always curative1
Recurrence is still a risk following surgery for TGCT.
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- Typically allows total resection3
- Generally, patients report
excellent or good clinical results
with surgical treatment3
Risk of
recurrence:
up to
15%7–10
- Diffuse nature poses complications, often resulting in incomplete resection3–5
- Incomplete tumor resection can lead to worse clinical outcomes4
Risk of
recurrence:
72%6
Risk of long-term joint damage
Repeated surgery can significantly impact joint health2,11
Even with complete surgical resection, there is a risk of recurrence, particularly with D-TGCT. With each recurrence, TGCT becomes increasingly difficult to manage, and patients face greater burden.11
- Multiple surgeries can result in increased morbidity4,11
- Joints are adversely affected:
- Partial loss of function11
- Acceleration of secondary osteoarthritis2
- Permanent joint damage can occur2,11
- In some cases, joint replacement or even amputation are required2,12
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D-TGCT, diffuse-type TGCT; LR, local relapse; LRR, local relapse rate; N-TGCT, nodular-type TGCT; PVNS, pigmented villonodular synovitis; QoL, quality of life; TGCT, tenosynovial giant cell tumor.
References:
- Stacchiotti S, et al. Cancer Treat Rev. 2023:112:102491.
- Robert M, et al. Front Immunol. 2022:13:820046.
- Gouin F., Noailles T. Orthop Traumatol Surg Res. 2017;103(1S):S91–S97.
- Spierenburg G, et al. J Surg Oncol. 2022;126(6):1087–1095.
- Choi WS, et al. Cancers (Basel). 2024;16(2):402.
- Stern S, et al. Future Oncol. 2025:1–10.
- Ehrenstein V, et al. J Rheumatol. 2017;44(10):1476–83.
- Palmerini E, et al. Eur J Cancer. 2015;51(2):210–7.
- Chiari C, et al. Clin Orthop Relat Res. 2006;450:172–8.
- Siegel M, et al. PLoS One. 2021;16(12):e0260795.
- Lopez-Bastida J, et al. Orphanet J Rare Dis. 2021;16(1):294.
- Gelderblom H, et al. Lancet. 2024;403(10445):2709–2719.
DCPH-P02495 | August 2025