Desmoid Tumor: Analysis of Prognostic Factors and Outcomes in a Surgical Series

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• 作者：John T. Mullen MD (1)
  Thomas F. DeLaney MD (2)
  Wendy K. Kobayashi BA (2)
  Jackie Szymonifka BA (3)
  Beow Y. Yeap ScD (3)
  Yen-Lin Chen MD (2)
  Andrew E. Rosenberg MD (4)
  David C. Harmon MD (5)
  Edwin Choy MD ; PhD (5)
  Sam S. Yoon MD (1)
  Kevin A. Raskin MD (6)
  G. Petur Nielsen MD (4)
  Francis J. Hornicek MD ; PhD (6)
  
• 刊名：Annals of Surgical Oncology
• 出版年：2012
• 出版时间：December 2012
• 年：2012
• 卷：19
• 期：13
• 页码：4028-4035
• 全文大小：450KB
• 参考文献：1. Alman BA, Pajerski ME, Diaz-Cano S, et al. Aggressive fibromatosis (desmoid tumor) is a monoclonal disorder. / Diagn Mol Pathol. 1997;6:98-01. CrossRef
  2. Li M, Cordon-Cardo C, Gerald WL, Rosai J. Desmoid fibromatosis is a clonal process. / Hum Pathol. 1996;27:939-3. CrossRef
  3. Bonvalot S, Eldweny H, Haddad V, et al. Extra-abdominal primary fibromatosis: aggressive management could be avoided in a subgroup of patients. / Eur J Surg Oncol. 2008;34:462-. j.ejso.2007.06.006">CrossRef
  4. Salas S, Dufresne A, Bui B, et al. Prognostic factors influencing progression-free survival determined from a series of sporadic desmoid tumors: a wait-and-see policy according to tumor presentation. / J Clin Oncol. 2011;29:3553-. CrossRef
  5. Acker JC, Bossen EH, Halperin EC. The management of desmoid tumors. / Int J Radiat Oncol Biol Phys. 1993;26:851-. CrossRef
  6. Karakousis CP, Mayordomo J, Zografos GC, Driscoll DL. Desmoid tumors of the trunk and extremity. / Cancer. 1993;72:1637-1. CrossRef
  7. Lopez R, Kemalyan N, Moseley HS, et al. Problems in diagnosis and management of desmoid tumors. / Am J Surg. 1990;159:450-. CrossRef
  8. McKinnon JG, Neifeld JP, Kay S, et al. Management of desmoid tumors. / Surg Gynecol Obstet. 1989;169:104-.
  9. Plukker JT, van Oort I, Vermey A, et al. Aggressive fibromatosis (non-familial desmoid tumour): therapeutic problems and the role of adjuvant radiotherapy. / Br J Surg. 1995;82:510-. js.1800820424">CrossRef
  10. Rock MG, Pritchard DJ, Reiman HM, et al. Extra-abdominal desmoid tumors. / J Bone Joint Surg Am. 1984;66:1369-4.
  11. Spear MA, Jennings LC, Mankin HJ, et al. Individualizing management of aggressive fibromatoses. / Int J Radiat Oncol Biol Phys. 1998;40:637-5. CrossRef
  12. Posner MC, Shiu MH, Newsome JL, et al. The desmoid tumor. Not a benign disease. / Arch Surg. 1989;124:191-. CrossRef
  13. Pritchard DJ, Nascimento AG, Petersen IA. Local control of extra-abdominal desmoid tumors. / J Bone Joint Surg Am. 1996;78:848-4.
  14. Sorensen A, Keller J, Nielsen OS, Jensen OM. Treatment of aggressive fibromatosis: a retrospective study of 72 patients followed for 1-7?years. / Acta Orthop Scand. 2002;73:213-. CrossRef
  15. Ballo MT, Zagars GK, Pollack A, et al. Desmoid tumor: prognostic factors and outcome after surgery, radiation therapy, or combined surgery and radiation therapy. / J Clin Oncol. 1999;17:158-7.
  16. Huang K, Fu H, Shi YQ, et al. Prognostic factors for extra-abdominal and abdominal wall desmoids: a 20-year experience at a single institution. / J Surg Oncol. 2009;100:563-. jso.21384">CrossRef
  17. Merchant NB, Lewis JJ, Woodruff JM, et al. Extremity and trunk desmoid tumors: a multifactorial analysis of outcome. / Cancer. 1999;86:2045-2. CrossRef
  18. Gronchi A, Casali PG, Mariani L, et al. Quality of surgery and outcome in extra-abdominal aggressive fibromatosis: a series of patients surgically treated at a single institution. / J Clin Oncol. 2003;21:1390-. CrossRef
  19. Lev D, Kotilingam D, Wei C, et al. Optimizing treatment of desmoid tumors. / J Clin Oncol. 2007;25:1785-1. CrossRef
  20. Goy BW, Lee SP, Eilber F, et al. The role of adjuvant radiotherapy in the treatment of resectable desmoid tumors. / Int J Radiat Oncol Biol Phys. 1997;39:659-5. CrossRef
  21. Nuyttens JJ, Rust PF, Thomas CR Jr, Turrisi AT 3rd. Surgery versus radiation therapy for patients with aggressive fibromatosis or desmoid tumors: a comparative review of 22 articles. / Cancer. 2000;88:1517-3. CrossRef
  22. Ballo MT, Zagars GK, Pollack A. Radiation therapy in the management of desmoid tumors. / Int J Radiat Oncol Biol Phys. 1998;42:1007-4. CrossRef
  23. Gluck I, Griffith KA, Biermann JS, et al. Role of radiotherapy in the management of desmoid tumors. / Int J Radiat Oncol Biol Phys. 2011;80:787-2. j.ijrobp.2010.02.053">CrossRef
  24. Micke O, Seegenschmiedt MH. Radiation therapy for aggressive fibromatosis (desmoid tumors): results of a national patterns of care study. / Int J Radiat Oncol Biol Phys. 2005;61:882-1. j.ijrobp.2004.07.705">CrossRef
  25. Patel SR, Evans HL, Benjamin RS. Combination chemotherapy in adult desmoid tumors. / Cancer. 1993;72:3244-. CrossRef
  26. de Camargo VP, Keohan ML, D’Adamo DR, et al. Clinical outcomes of systemic therapy for patients with deep fibromatosis (desmoid tumor). / Cancer. 2010;116:2258-5.
  27. Fiore M, Rimareix F, Mariani L, et al. Desmoid-type fibromatosis: a frontline conservative approach to select patients for surgical treatment. / Ann Surg Oncol. 2009;16:2587-3. CrossRef
  
• 作者单位：John T. Mullen MD (1)
  Thomas F. DeLaney MD (2)
  Wendy K. Kobayashi BA (2)
  Jackie Szymonifka BA (3)
  Beow Y. Yeap ScD (3)
  Yen-Lin Chen MD (2)
  Andrew E. Rosenberg MD (4)
  David C. Harmon MD (5)
  Edwin Choy MD, PhD (5)
  Sam S. Yoon MD (1)
  Kevin A. Raskin MD (6)
  G. Petur Nielsen MD (4)
  Francis J. Hornicek MD, PhD (6)
  
  1. Division of Surgical Oncology, Massachusetts General Hospital, Boston, MA
  2. Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA
  3. Department of Medicine, Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA
  4. Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
  5. Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
  6. Orthopedic Oncology Service, Massachusetts General Hospital, Boston, MA, USA
  

文摘

Background Desmoid tumors are rare and exhibit a highly unpredictable natural history. We sought to analyze prognostic factors associated with recurrence in a large single-institution study of patients with desmoid tumors. Methods We performed a retrospective review of 177 patients with desmoid tumor who underwent macroscopically complete surgical resection, with or without the addition of radiotherapy (RT) or systemic therapy, from 1970 to 2009. We examined patterns of presentation, all known risk factors for recurrence, and their association with recurrence-free survival (RFS). Results Twenty-two patients (12?%) had intra-abdominal desmoid tumors, and 155 (88?%) had extra-abdominal tumors. Patterns of presentation included primary (n?=?133, 75?%) and locally recurrent (n?=?44, 25?%) disease. Treatment was surgery alone in 125 patients (71?%), surgery and RT in 36 (20?%), and surgery and systemic therapy with or without RT in 20 (11?%). Median follow-up was 40?months. Overall, the local relapse rate was 29?%, and 10-year RFS was 60?%. R0 resection status was the only predictor of freedom from local recurrence on multivariate analysis (odds ratio 0.32; 95?% confidence interval 0.15-.66; P?=?0.002). The selective use of adjuvant RT appeared to improve local control in patients with positive margins. Conclusions For patients with desmoid tumors undergoing surgery, wide excision with negative margins should be the goal, but not at the expense of function, as fewer than half of patients with positive margins will experience recurrence.