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. 2012 Sep 10:10:184.
doi: 10.1186/1477-7819-10-184.

Recurrence and prognostic factors in patients with aggressive fibromatosis. The role of radical surgery and its limitations

Emilio Bertani  1 , Alessandro Testori, Antonio Chiappa, Pasquale Misitano, Roberto Biffi, Giuseppe Viale, Giovanni Mazzarol, Tommaso De Pas, Edoardo Botteri, Gianmarco Contino, Francesco Verrecchia, Barbara Bazolli, Bruno Andreoni
Affiliations

Recurrence and prognostic factors in patients with aggressive fibromatosis. The role of radical surgery and its limitations

Emilio Bertani et al. World J Surg Oncol. .

Abstract

Background: Surgery is still the standard treatment for aggressive fibromatosis (AF); however, local control remains a significant problem and the impact of R0 surgery on cumulative recurrence (CR) is objective of contradictory reports.

Methods: This is a single-institution study of 62 consecutive patients affected by extra-abdominal and intra-abdominal AF who received macroscopically radical surgery within a time period of 15 years.

Results: Definitive pathology examination confirmed an R0 situation in 49 patients and an R1 in 13 patients. Five-year CR for patients who underwent R0 vs R1 surgery was 7.1% vs 46.4% (P = 0.04) and for limbs vs other localizations 33.3% vs 9.9% (P = 0.02) respectively. In 17 patients who had intraoperative frozen section (IFS) margin evaluation R0 surgery was more common (17 of 17 vs 32 of 45, P = 0.01) and CR lower (five-year CR 0% vs 19.1%, respectively, P = 0.04). However, in multivariate analysis only limb localization showed a negative impact on CR (HR: 1.708, 95% CI 1.03 to 2.84, P = 0.04).

Conclusions: IFS evaluation could help the surgeon to achieve R0 surgery in AF. Non-surgical treatment, including watchful follow-up, could be indicated for patients with limb AF localization, because of their high risk of recurrence even after R0 surgery.

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Figures

Figure 1
Figure 1
Impact of R0 vs R1 surgery on CR for the 62 patients.
Figure 2
Figure 2
Impact of tumor localization (limbs vs no limbs).
Figure 3
Figure 3
Impact of performing IFS on CR.
See this image and copyright information in PMC

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References

    1. Li M, Cordon-Cardo C, Gerald WL, Rosai J. Desmoid fibromatosis is a clonal process. Hum Pathol. 1996;27:939–943. doi: 10.1016/S0046-8177(96)90221-X. - DOI - PubMed
    1. Escobar C, Munker R, Thomas JO, Li BD, Burton GV. Update on desmoid tumors. Ann Oncol. 2011;23:562–569. - PubMed
    1. Rüdiger HA, Ngan SY, Ng M, Powell GJ, Choong PF. Radiation therapy in the treatment of desmoid tumours reduces surgical indications. Eur J Surg Oncol. 2010;36:84–88. doi: 10.1016/j.ejso.2009.07.183. - DOI - PubMed
    1. Gluck I, Griffith KA, Biermann JS, Feng FY, Lucas DR, Ben-Josef E. Role of radiotherapy in the management of desmoid tumors. Int J Radiat Oncol Biol Phys. 2011;80:787–792. doi: 10.1016/j.ijrobp.2010.02.053. - DOI - PubMed
    1. Nishida Y, Tsukushi S, Shido Y, Wasa J, Ishiguro N, Yamada Y. Successful treatment with meloxicam, a cyclooxygenase-2 inhibitor, of patients with extra-abdominal desmoid tumors: a pilot study. J Clin Oncol. 2010;28:107–109. doi: 10.1200/JCO.2009.25.5950. - DOI - PubMed

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