Multidisciplinary care in tenosynovial giant cell tumours
Menée à partir de données portant sur 1 192 patients atteints d'une tumeur ténosynoviale à cellules géantes de type diffus traité entre 1990 et 2017 (durée médiane de suivi : 54 mois), cette étude multicentrique analyse les caractéristiques des protocoles chirurgicaux, puis évalue l'efficacité de ces derniers du point de vue de la survie sans récidive à 3, 5 et 10 ans ainsi que les complications associées
Tenosynovial giant cell tumour is a rare neoplastic condition of the joint that generally affects patients younger than 40 years. It is not a malignancy per se, but for many, it is far from a benign disease and often causes substantial morbidity and disability due to pain, joint destruction, the need for repeated surgical intervention, and the use of analgesics and narcotics. Although not life-threatening, tenosynovial giant cell tumours can disrupt daily living and adversely alter an individual's life trajectory. Tenosynovial giant cell tumour is a complex disease with a wide breadth of clinical sequalae. Understanding of this disease has changed substantially in the past 10 years after causative genomic events were described. The discovery of these genomic events has allowed for the development and application of promising therapeutics targeting CSF1 signalling, which are further driving our knowledge base and greatly informing clinical practice. The introduction of CSF1 receptor inhibitors came with the realisation that much needed to be learned about what patients with tenosynovial giant cell tumours go through and how the medical community could best serve them. This realisation prompted the medical and pharmaceutical community to partner with patients, patient advocacy, and patient support groups to learn more about the disease, to develop novel patient-reported outcome measures and potentially new imaging techniques, and to review and scrutinise historical experiences. This effort is paramount because the correct application of targeted therapies in tenosynovial giant cell tumours is not straightforward. Although active, many drugs have serious side-effects and associated financial costs. Much still needs to be learned about appropriate application, patient selection, timing of therapy, and length of use; decisions that need to be made in a multidisciplinary fashion, inclusive of the patient and their care team.
The Lancet Oncology , commentaire, 2018