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

Emilio Bertani, 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

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Article number184
JournalWorld Journal of Surgical Oncology
Volume10
DOIs
Publication statusPublished - Sep 10 2012

Keywords

  • Aggressive fibromatosis
  • Desmoid tumors
  • Frozen sections
  • Local recurrence
  • Risk factors
  • Surgery

ASJC Scopus subject areas

  • Oncology
  • Surgery

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