{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T17:14:54Z","timestamp":1792430094538,"version":"4.5.0"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T00:00:00Z","timestamp":1655942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Surgery is the mainstay of treatment for tenosynovial giant cell tumors (TGCTs). However, achieving a cure through surgery alone remains challenging, especially for the diffuse\u2010type (D\u2010TGCT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Our goal was to describe the surgical management of patients with D\u2010TGCT related to large joints, treated between 2000 and 2020. We analyzed the effect of (in)complete resections and the presence of postoperative tumor (POT) on magnetic resonance imaging\u00a0(MRI) on radiological and clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 144 patients underwent open surgery for D\u2010TGCT, of which 58 (40%) had treatment before. The median follow\u2010up was 65 months. One hundred twenty\u2010five patients underwent isolated open surgeries, in which 25 (20%) patients' D\u2010TGCT was intentionally removed incompletely. POT presence on the first postoperative MRI was observed in 64%. Both incomplete resections and POT presence were associated with higher rates of radiological progression (73% vs. 44%; Kaplan\u2013Meier\u00a0[KM]\u00a0analysis <jats:italic>p<\/jats:italic>\u2009=\u20090.021) and 59% versus 7%; KM\u00a0analysis <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), respectively. Furthermore, patients with POT presence clinically worsened more often than patients without having POT (49% vs. 24%; KM\u00a0analysis <jats:italic>p<\/jats:italic>\u2009=\u20090.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>D\u2010TGCT is often resected incompletely and tumor presence is commonly observed on the first postoperative MRI, resulting in worse radiological and clinical outcomes. Therefore, surgeons should try to remove D\u2010TGCT in toto and consider other multimodal therapeutic strategies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.26991","type":"journal-article","created":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T14:54:23Z","timestamp":1655996063000},"page":"1087-1095","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Surgical management of 144 diffuse\u2010type TGCT patients in a single institution: A 20\u2010year cohort study"],"prefix":"10.1002","volume":"126","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0236-7338","authenticated-orcid":false,"given":"Geert","family":"Spierenburg","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4440-793X","authenticated-orcid":false,"given":"Lizz","family":"van der Heijden","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8980-3955","authenticated-orcid":false,"given":"Monique J. L.","family":"Mastboom","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8871-9081","authenticated-orcid":false,"given":"Kirsten","family":"van Langevelde","sequence":"additional","affiliation":[{"name":"Department of Radiology Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J. P.","family":"van der Wal","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9270-8636","authenticated-orcid":false,"given":"Hans","family":"Gelderblom","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9156-7656","authenticated-orcid":false,"given":"Michiel A. 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