DIAGNOSTIC PATHWAYS, HEALTHCARE RESOURCE USE, AND PREDIAGNOSTIC TREATMENT BURDEN IN TENOSYNOVIAL GIANT CELL TUMOR (TGCT): A REAL-WORLD COHORT STUDY IN JAPAN
Author(s)
Makoto Endo, MD, PhD1, Doreen Kahangire, MSc2, Emmanuelle Boutmy, PhD3, Shoko Nakamura, PhD4, Hikaru Oya, N/A5, Takumi Tajima, N/A5, Katrin Kupas, PhD3, Akira Kawai, MD6.
1Kyushu University Hospital, Fukuoka, Japan, 2Consultancy services on behalf of Merck Healthcare KGaA, Darmstadt, Germany, 3Merck Healthcare KGaA, Darmstadt, Germany, 4Merck Biopharma Co., Ltd. Japan (an affiliate of Merck KGaA, Darmstadt, Germany), Tokyo, Japan, 5JMDC Inc., Tokyo, Japan, 6National Cancer Center Hospital, Tokyo, Japan.
1Kyushu University Hospital, Fukuoka, Japan, 2Consultancy services on behalf of Merck Healthcare KGaA, Darmstadt, Germany, 3Merck Healthcare KGaA, Darmstadt, Germany, 4Merck Biopharma Co., Ltd. Japan (an affiliate of Merck KGaA, Darmstadt, Germany), Tokyo, Japan, 5JMDC Inc., Tokyo, Japan, 6National Cancer Center Hospital, Tokyo, Japan.
OBJECTIVES: TGCT is a rare, locally aggressive soft-tissue tumor linked to functional limitations and repeated healthcare resource utilization (HCRU). As symptoms are often nonspecific, patients may undergo several diagnostic tests and receive non-TGCT targeted treatments before diagnosis. This study examined diagnostic pathways, HCRU, and prediagnostic treatment patterns in TGCT using real-world data.
METHODS: This noninterventional, noncomparative cohort analysis was based on secondary use of data from the JMDC Claims Database (2014-2024). Adults (≥18 years) with newly identified TGCT (2015-2024) and ≥12 months of baseline data were included. Adults aged ≥75 years were excluded, as Japan's Latter-Stage Elderly Healthcare System is not included in the JMDC Claims Database. Diagnostic approaches, healthcare specialties involved, and non-TGCT systemic treatments used pre-diagnosis were described as proxies for HCRU.
RESULTS: The analysis included 2186 incident patients with TGCT (median age 48 years; 51.6% female). The most frequent diagnostic modalities were biopsy (77.5%), radiography/X-ray (76.6%), histopathologic confirmation excluding biopsy (70.8%), computed tomography (64.7%), and magnetic resonance imaging (58.0%). Most diagnoses were made in orthopedic settings (61.9%), with involvement of dermatology (16.9%), plastic surgery (13.2%) and general internal medicine (6%). A total of 91.6% of patients received non-TGCT targeted prediagnostic systemic therapy, including combination regimens (44.8%), nonsteroidal anti-inflammatory drugs (22.8%), and corticosteroids (10.3%). There was a high prevalence of musculoskeletal comorbidities (arthritis 30.4%, bursitis 20.5%, osteoarthritis 19%).
CONCLUSIONS: Management of TGCT before diagnosis in Japan is marked by substantial HCRU, including repeated, resource-intensive, multimodal diagnostic procedures, and cross-specialty care. Extensive use of nonspecific therapies indicates symptomatic management and repeated healthcare encounters. Musculoskeletal comorbidities suggest diagnostic complexity and possible misclassification. These patterns indicate inefficiencies and potential delays in diagnosis, along with associated economic burden. Earlier recognition, more streamlined referral pathways, and adoption of targeted treatment strategies may help reduce unnecessary resource use and improve patient outcomes.
METHODS: This noninterventional, noncomparative cohort analysis was based on secondary use of data from the JMDC Claims Database (2014-2024). Adults (≥18 years) with newly identified TGCT (2015-2024) and ≥12 months of baseline data were included. Adults aged ≥75 years were excluded, as Japan's Latter-Stage Elderly Healthcare System is not included in the JMDC Claims Database. Diagnostic approaches, healthcare specialties involved, and non-TGCT systemic treatments used pre-diagnosis were described as proxies for HCRU.
RESULTS: The analysis included 2186 incident patients with TGCT (median age 48 years; 51.6% female). The most frequent diagnostic modalities were biopsy (77.5%), radiography/X-ray (76.6%), histopathologic confirmation excluding biopsy (70.8%), computed tomography (64.7%), and magnetic resonance imaging (58.0%). Most diagnoses were made in orthopedic settings (61.9%), with involvement of dermatology (16.9%), plastic surgery (13.2%) and general internal medicine (6%). A total of 91.6% of patients received non-TGCT targeted prediagnostic systemic therapy, including combination regimens (44.8%), nonsteroidal anti-inflammatory drugs (22.8%), and corticosteroids (10.3%). There was a high prevalence of musculoskeletal comorbidities (arthritis 30.4%, bursitis 20.5%, osteoarthritis 19%).
CONCLUSIONS: Management of TGCT before diagnosis in Japan is marked by substantial HCRU, including repeated, resource-intensive, multimodal diagnostic procedures, and cross-specialty care. Extensive use of nonspecific therapies indicates symptomatic management and repeated healthcare encounters. Musculoskeletal comorbidities suggest diagnostic complexity and possible misclassification. These patterns indicate inefficiencies and potential delays in diagnosis, along with associated economic burden. Earlier recognition, more streamlined referral pathways, and adoption of targeted treatment strategies may help reduce unnecessary resource use and improve patient outcomes.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
RWD168
Topic
Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
Oncology, Rare & Orphan Diseases