Extra-abdominal desmoid tumor fibromatosis: a multicenter EMSOS study.
Adolescent
Adult
Aged
Aged, 80 and over
Biopsy
Child
Child, Preschool
Combined Modality Therapy
Disease Management
Disease Progression
Female
Fibromatosis, Abdominal
/ diagnosis
Fibromatosis, Aggressive
/ diagnosis
Humans
Male
Middle Aged
Prognosis
Recurrence
Retrospective Studies
Treatment Outcome
Young Adult
Journal
BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800
Informations de publication
Date de publication:
20 Apr 2021
20 Apr 2021
Historique:
received:
10
11
2020
accepted:
12
04
2021
entrez:
21
4
2021
pubmed:
22
4
2021
medline:
11
5
2021
Statut:
epublish
Résumé
Extra-abdominal desmoid tumor fibromatosis (DTF) is a rare, locally aggressive soft tissue tumour. The best treatment modality for this patient cohort is still object of debate. This paper aimed to (1) to compare the outcomes of DTF after different treatment modalities, (2) to assess prognostic factors for recurrence following surgical excision, and (3) to assess prognostic factors for progression during observation. This was a retrospective multicenter study under the patronage of the European Musculoskeletal Oncology Society (EMSOS). All seven centres involved were tertiary referral centres for soft tissue tumours. Baseline demographic data was collected for all patients as well as data on the diagnosis, tumour characteristics, clinical features, treatment modalities and whether they had any predisposing factors for DTF. Three hundred eighty-eight patients (240 female, 140 male) with a mean age of 37.6 (±18.8 SD, range: 3-85) were included in the study. Two hundred fifty-seven patients (66%) underwent surgical excision of ADF, 70 patients (18%) were observed without therapy, the residual patients had different conservative treatments. There were no significant differences in terms of tumour recurrence or progression between the different treatment groups. After surgical excision, younger age, recurrent disease and larger tumour size were risk factors for recurrence, while tumours around the shoulder girdle and painful lesions were at risk of progression in the observational group. Local recurrence rate after surgery was similar to progression rates under observation. Hence, observation in DTF seems to be justified, considering surgery in case of dimensional progression in 2 consecutive controls (3 and 6 months) and in painful lesions, with particular attention to lesions around the shoulder girdle.
Sections du résumé
BACKGROUND
BACKGROUND
Extra-abdominal desmoid tumor fibromatosis (DTF) is a rare, locally aggressive soft tissue tumour. The best treatment modality for this patient cohort is still object of debate.
QUESTIONS/PURPOSE
OBJECTIVE
This paper aimed to (1) to compare the outcomes of DTF after different treatment modalities, (2) to assess prognostic factors for recurrence following surgical excision, and (3) to assess prognostic factors for progression during observation.
METHODS
METHODS
This was a retrospective multicenter study under the patronage of the European Musculoskeletal Oncology Society (EMSOS). All seven centres involved were tertiary referral centres for soft tissue tumours. Baseline demographic data was collected for all patients as well as data on the diagnosis, tumour characteristics, clinical features, treatment modalities and whether they had any predisposing factors for DTF.
RESULTS
RESULTS
Three hundred eighty-eight patients (240 female, 140 male) with a mean age of 37.6 (±18.8 SD, range: 3-85) were included in the study. Two hundred fifty-seven patients (66%) underwent surgical excision of ADF, 70 patients (18%) were observed without therapy, the residual patients had different conservative treatments. There were no significant differences in terms of tumour recurrence or progression between the different treatment groups. After surgical excision, younger age, recurrent disease and larger tumour size were risk factors for recurrence, while tumours around the shoulder girdle and painful lesions were at risk of progression in the observational group.
CONCLUSION
CONCLUSIONS
Local recurrence rate after surgery was similar to progression rates under observation. Hence, observation in DTF seems to be justified, considering surgery in case of dimensional progression in 2 consecutive controls (3 and 6 months) and in painful lesions, with particular attention to lesions around the shoulder girdle.
Identifiants
pubmed: 33879110
doi: 10.1186/s12885-021-08189-6
pii: 10.1186/s12885-021-08189-6
pmc: PMC8059004
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
437Références
J Bone Joint Surg Am. 1984 Dec;66(9):1369-74
pubmed: 6501332
Pathology. 2014 Feb;46(2):135-40
pubmed: 24378386
Surg Oncol Clin N Am. 2016 Oct;25(4):803-26
pubmed: 27591500
Eur J Surg Oncol. 2008 Apr;34(4):462-8
pubmed: 17709227
J Surg Oncol. 2009 Dec 1;100(7):563-9
pubmed: 19722232
J Thorac Oncol. 2016 Feb;11(2):142-54
pubmed: 26811225
N Engl J Med. 2018 Dec 20;379(25):2417-2428
pubmed: 30575484
Proc Natl Acad Sci U S A. 2002 May 14;99(10):6973-8
pubmed: 11983872
Surg Oncol. 2007 Aug;16(2):131-42
pubmed: 17719772
J Clin Oncol. 2003 Apr 1;21(7):1390-7
pubmed: 12663732
Oncol Ther. 2016;4(1):57-72
pubmed: 28261640
Cancer. 2004 Feb 1;100(3):612-20
pubmed: 14745880
Eur J Surg Oncol. 2016 Jul;42(7):1071-83
pubmed: 26965303
Int J Radiat Oncol Biol Phys. 2001 May 1;50(1):121-5
pubmed: 11316554
Acta Ortop Bras. 2016 May-Jun;24(3):147-50
pubmed: 27217816
Arch Surg. 1989 Feb;124(2):191-6
pubmed: 2916941
Int J Radiat Oncol Biol Phys. 1998 Feb 1;40(3):637-45
pubmed: 9486614
Ann Oncol. 2014 Mar;25(3):578-583
pubmed: 24325833
Br J Surg. 2004 Dec;91(12):1624-9
pubmed: 15505878
Int J Radiat Oncol Biol Phys. 1997 Oct 1;39(3):659-65
pubmed: 9336146
Am J Clin Pathol. 1982 Jun;77(6):665-73
pubmed: 7091046
J Bone Joint Surg Am. 2014 Apr 16;96(8):631-8
pubmed: 24740659
Dis Colon Rectum. 2008 Jun;51(6):897-901
pubmed: 18322756
Int J Radiat Oncol Biol Phys. 2002 Sep 1;54(1):177-181
pubmed: 12182989
Eur J Cancer. 2020 Mar;127:96-107
pubmed: 32004793
Ann Surg Oncol. 2015 Sep;22(9):2817-23
pubmed: 26045393
Ann Oncol. 2017 Oct 1;28(10):2399-2408
pubmed: 28961825
Cancer. 2000 Apr 1;88(7):1517-23
pubmed: 10738207
Cancer. 1999 Nov 15;86(10):2045-52
pubmed: 10570430
J Surg Oncol. 2004 Jun 1;86(3):152-6
pubmed: 15170654
J Surg Oncol. 2010 Oct 1;102(5):380-4
pubmed: 19877160
Br J Surg. 1999 Sep;86(9):1185-9
pubmed: 10504375
World J Surg Oncol. 2012 Sep 10;10:184
pubmed: 22963172
J Bone Joint Surg Br. 1996 Jul;78(4):658-61
pubmed: 8682838
J Clin Oncol. 2011 Sep 10;29(26):3553-8
pubmed: 21844500
J Clin Oncol. 2006 Mar 1;24(7):1195-203
pubmed: 16505440
J Clin Oncol. 1999 Jan;17(1):158-67
pubmed: 10458229
Eur J Surg Oncol. 2014 Sep;40(9):1125-30
pubmed: 24612653
Acta Orthop Scand. 2002 Apr;73(2):213-9
pubmed: 12079022
Clin Orthop Relat Res. 2000 Jun;(375):207-13
pubmed: 10853171
J Biol Regul Homeost Agents. 2018 Nov-Dec;32(6 Suppl. 1):65-70
pubmed: 30644284
Ann Surg. 2013 Aug;258(2):347-53
pubmed: 23532110
J Clin Oncol. 2006 Jan 1;24(1):11-2
pubmed: 16330666