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The management of extra-abdominal desmoid tumours

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Abstract

We performed a retrospective analysis of 35 cases of desmoid tumours (aggressive fibromatoses) that underwent treatment at our institutions between 1987 and 2002. The purpose was to evaluate the rate of local recurrence of desmoid tumours treated with surgical excision, to assess the impact of surgical margins on local recurrence and to define the role of radiotherapy in the treatment. Nine patients experienced a recurrence at an average of 16 months after initial treatment. Seven of the 15 patients with a less-than-wide margin had a local recurrence. Comparatively, only two of the 20 patients with a wide margin had a local recurrence. Thirty-three of the 35 patients were disease free at the last follow-up. We recommend wide excision with clear margins whenever possible. Marginal resections are appropriate when wide excision would severely compromise the function of the limb. Surgical resections and selective supplementation of adjuvant radiotherapy give excellent control rates.

Résumé

Nous avons exécuté une analyse rétrospective de 35 cas de tumeurs desmoides (fibromatose agressive) traitées dans notre institution entre 1987 et 2002. Le but était d’évaluer le taux de récidive locale après traitement par excision chirurgicale, d’étudier le rôle des marges chirurgicales sur la récidive et de définir le rôle de la radiothérapie dans le traitement. Neuf malades ont eu une récidive à une moyenne de 16 mois après le traitement initial. Sept des 15 malades opérés avec une marge qui n’était pas large, avait une récidive locale. Comparativement, seulement 2 des 20 malades avec une marge large avaient une récidive locale. Trente trois des 35 malades étaient sans maladie au dernier suivi. Nous recommandons l’excision large avec des marges claires toutes les fois que possible. Les résections marginales sont appropriées quand l’excision large compromettrait sévèrement la fonction du membre. Les résections chirurgicales avec, sélectivement, un traitement adjuvant par radiothérapie donnent d’excellents taux de contrôle de la maladie.

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References

  1. Baliski CR, Temple WJ, Arthur K, Schachar NS (2002) Desmoid tumors: a novel approach for local control. J Surg Oncol 80:96–99

    Article  PubMed  Google Scholar 

  2. Ballo MT, Zagars GK, Pollack A (1998) Radiation therapy in the management of desmoid tumors. Int J Radiat Oncol Biol Phys 42:1007–1014

    Article  CAS  PubMed  Google Scholar 

  3. Ballo MT, Zagars GK, Pollack A, Pisters PW, Pollock RA (1999) Desmoid tumor: prognostic factors and outcome after surgery, radiation therapy, or combined surgery and radiation therapy. J Clin Oncol 17:158–167

    CAS  PubMed  Google Scholar 

  4. Dalen BP, Bergh PM, Gunterberg BU (2003) Desmoid tumors: a clinical review of 30 patients with more than 20 years’ follow-up. Acta Orthop Scand 74:455–459

    Article  PubMed  Google Scholar 

  5. Enzinger FM, Weiss SW (1995) Fibromatoses. Soft tissue tumors, 4th edn. Mosby, St. Louis, pp 320–329

  6. Goy BW, Lee SP, Eilber F, Dorey F, Eckardt J, Fu YS, Juillard GJ, Selch MT (1997) The role of adjuvant radiotherapy in the treatment of resectable desmoid tumors. Int J Radiat Oncol Biol Phys 39:659–665

    Article  CAS  PubMed  Google Scholar 

  7. Jelinek JA, Stelzer KJ, Conrad E, Bruckner J, Kliot M, Koh W, Laramore GE (2001) The efficacy of radiotherapy as postoperative treatment for desmoid tumors. Int J Radiat Oncol Biol Phys 50:121–125

    Article  CAS  PubMed  Google Scholar 

  8. Karakousis CP, Mayordomo J, Zografos GC, Driscoll DL (1993) Desmoid tumors of the trunk and extremity. Cancer 72:1637–1641

    CAS  PubMed  Google Scholar 

  9. Lewis JJ, Boland PJ, Leung DH, Woodruff JM, Brennan MF (1999) The enigma of desmoid tumors. Ann Surg 229:866–872 (discussion 872–873)

    Article  CAS  PubMed  Google Scholar 

  10. McCollough WM, Parsons JT, van der Griend R, Enneking WF, Heare T (1991) Radiation therapy for aggressive fibromatosis. The experience at the university of Florida. J Bone Joint Surg Am 73:717–725

    CAS  PubMed  Google Scholar 

  11. Mehrotra AK, Sheikh S, Aaron AD, Montgomery E (2000) Fibromatoses of the extremities: clinicopathologic study of 36 cases. J Surg Oncol 74:291–296

    Article  CAS  PubMed  Google Scholar 

  12. Merchant NB, Lewis JL, Woodruff JM, Leung DH, Brennan MF (1999) Extremity and trunk desmoid tumors. A multifactorial analysis of outcome. Cancer 86:2045–2052

    Article  CAS  PubMed  Google Scholar 

  13. Nuyttens JJ, Rust PF, Thomas CR Jr, Turrisi AT III (2000) Surgery versus radiation therapy for patients with aggressive fibromatosis or desmoid tumors. A comparative review of 22 articles. Cancer 88:1517–1523

    Article  CAS  PubMed  Google Scholar 

  14. Okuno SH, Edmonson JH (2003) Combination chemotherapy for desmoid tumors. Cancer 97:1134–1135

    Article  PubMed  Google Scholar 

  15. Pignatti G, Barbanti-Brodano G, Ferrari D, Gherlinzoni F, Bertoni F, Bacchini P, Barbieri E, Giunti A, Campanacci M (2000) Extraabdominal desmoid tumor: a study of 83 cases. Clin Orthop 375:207–213

    PubMed  Google Scholar 

  16. Posner MC, Shiu MH, Newsome JL, Hajdu SI, Gaynor JJ, Brennan MF (1989) The Desmoid tumor. Not a benign disease. Arch Surg 124:191–196

    CAS  PubMed  Google Scholar 

  17. Pritchard DJ, Nascimento AG, Petersen IA (1996) Local control of extra-abdominal desmoid tumors. J Bone Joint Surg Am 78:848–854

    CAS  PubMed  Google Scholar 

  18. Reitamo JJ, Scheinin TM, Hayry P (1986) The desmoid syndrome. New aspects in the cause, pathogenesis and treatment of the desmoid tumor. Am J Surg 151:230–237

    CAS  PubMed  Google Scholar 

  19. Rock MG, Pritchard DJ, Reiman HM, Soule EH, Brewster RC (1984) Extra-abdominal desmoid tumors. J Bone Joint Surg Am 66:1369–1374

    CAS  PubMed  Google Scholar 

  20. Selch MT (1997) The role of adjuvant radiotherapy in the treatment of respectable desmoid tumors. Int J Radiat Oncol Biol Phys 39:659–665

    Article  CAS  PubMed  Google Scholar 

  21. Shields CJ, Winter DC, Kirwan WO, Redmond HP (2001) Desmoid tumours. Eur J Surg Oncol 27:701–706

    Article  CAS  PubMed  Google Scholar 

  22. Sorensen A, Keller J, Nielsen OS, Jensen OM (2002) Treatment of aggressive fibromatosis. A retrospective study of 72 patients followed for 1–27 years. Acta Orthop Scand 73:213–219

    Article  PubMed  Google Scholar 

  23. Spear MA, Jennings LC, Mankin HJ, Spiro IJ, Springfield DS, Gebhardt MC, Rosenberg AE, Efird JT, Suit HD (1998) Individualizing management of aggressive fibromatoses. Int J Radiat Oncol Biol Phys 40:637–645

    Article  CAS  PubMed  Google Scholar 

  24. Zlotecki RA, Scarborough MT, Morris CG, Berrey BH, Lind DS, Enneking WF, Marcus RB Jr (2002) External beam radiotherapy for primary and adjuvant management of aggressive fibromatosis. Int J Radiat Oncol Biol Phys 54:177–181

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Princess Alexandra Hospital and The Wesley Medical Centre, 40 Chasely Street, Auchenflower, Brisbane, 4066, Australia

    Amit Duggal, Ian C. Dickinson, Scott Sommerville & Price Gallie

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  1. Amit Duggal
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  2. Ian C. Dickinson
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  3. Scott Sommerville
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  4. Price Gallie
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Correspondence to Ian C. Dickinson.

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Duggal, A., Dickinson, I.C., Sommerville, S. et al. The management of extra-abdominal desmoid tumours. International Orthopaedics (SICOT) 28, 252–256 (2004). https://doi.org/10.1007/s00264-004-0571-0

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