Author:
Khan Misbah,Almond Max,Ford Samuel,Desai Anant
Abstract
Abstract
Background
Desmoids are rare fibroblastic tumours whose treatment in any individual case presents a persistent challenge. We endeavoured to evaluate various clinicopathological factors contributing to tumour behaviour.
Methods
This is a retrospective review of 95 primary truncal sporadic fibromatosis managed between 2011 and 2020. We studied progression rate for wait and watch (WW) and recurrence rate for the surgically treated group as adverse events. Relevant event-free survivals and potential risk factors were analysed over a median follow-up of 27 months.
Results
66 patients (69.5%) received watchful surveillance and 28 upfront surgery. 2-year progression-free survival in WW group (88.9%) was higher than RFS in the surgical group (77.1%) p = 0.02. Adverse event rate compared favourably, 28.8% in WW and 28.6% in surgical group. At final follow-up, rate of stable disease for WW was 47%, and the regression rate was 24.2%. On Cox regression analysis, meantime to progress was 14 ± 2.0 months, with larger tumour size as a significant prognostic indicator (p = 0.05). Surgical group's mean time to recurrence was 13.8 ± 2.76 months, with tumour location a significant contributing factor (p = 0.05).
Conclusions
This study confirms to the safety of both treatment approaches. Adverse event rates remained comparable, but event-free survival was longer for the watchful surveillance group.
Publisher
Springer Science and Business Media LLC
Reference29 articles.
1. Wu C, Amini-Nik S, Nadesan P, Stanford WL, Alman BA. Aggressive fibromatosis (desmoid tumor) is derived from mesenchymal progenitor cells. Cancer Res. 2010;70(19):7690–8. https://doi.org/10.1158/0008-5472.CAN-10-1656.
2. Laura M, Rosenberg M, Hull A, Mullen JT. Desmoid Tumors. In: Morita SY, Balch CM, Klimberg VS, Pawlik TM, Posner MC, Tanabe KK, editors. Text book of complex general surgical oncology. New York: McGraw Hill; 2018.
3. WHO Classification of Tumours Editorial Board. WHO classification of tumours of soft tissue and bone. 5th ed. Lyon: IARC Press; 2020.
4. Nieuwenhuis MH, Mathus-Vliegen EM, Baeten CG, et al. Evaluation of management of desmoid tumours associated with familial adenomatous polyposis in Dutch patients. Br J Cancer. 2011;104(1):37–42. https://doi.org/10.1038/sj.bjc.6605997.
5. Ganeshan D, Amini B, Nikolaidis P, et al. Current Update on desmoid fibromatosis. J Comput Assist Tomogr. 2019;43(1):29–38. https://doi.org/10.1097/RCT.0000000000000790.