Surgical treatment for local control of extremity and trunk desmoid tumors

Shido, Yoji; Nishida, Yoshihiro; Nakashima, Hiroatsu; Katagiri, Hirohisa; Sugiura, Hideshi; Yamada, Yoshihisa; Ishiguro, Naoki

doi:10.1007/s00402-008-0750-3

Cited by 54 publications

(51 citation statements)

References 22 publications

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“…However, previous studies have reported inconsistent results regarding the association between the microscopic margin status and the recurrence rate [2][3][4][5][6][7][8][9]. No definitive conclusion has been reached regarding the significance of the histological margin status.…”

Section: Introductionmentioning

confidence: 85%

Low-dose chemotherapy with methotrexate and vinblastine for patients with desmoid tumors: relationship to CTNNB1 mutation status

et al. 2015

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Section: Introductionmentioning

confidence: 85%

Low-dose chemotherapy with methotrexate and vinblastine for patients with desmoid tumors: relationship to CTNNB1 mutation status

et al. 2015

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“…Until 2003, patients with extraperitoneal desmoid tumors were surgically treated with wide surgical margins; however, an unsatisfactory recurrence rate, even in cases with microscopically negative margins (9), prompted a treatment change to meloxicam, a COX-2 inhibitor, from 2003 onwards, based on the results of a study using genetically modified mice (16). Meloxicam treatment for patients with extraperitoneal desmoid tumors was approved by the Institutional Review Board of the Center for Advanced Medicine and Clinical Research of Nagoya University (Nagoya, Japan).…”

Section: Methodsmentioning

confidence: 99%

“…This type of tumor does not metastasize, but is highly locally invasive, and exhibits a propensity for recurrence, even following aggressive surgery with free surgical margin (1). Surgery has been the mainstay of treatment for desmoid tumors; however, there has been controversy about the association between the microscopic margin status and recurrence rates (2)(3)(4)(5)(6)(7)(8)(9), and therefore, no definitive conclusion has been reached regarding the significance of the histological margin status.…”

Section: Introductionmentioning

confidence: 99%

Simple resection of truncal desmoid tumors: A case series

et al. 2016

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Abstract. Desmoid tumors of the extra-abdominal and abdominal wall have been associated with morbidity due to the aggressive nature of the surgery and high recurrence rates. Surgery that does not cause functional impairment is desired for patients with desmoid tumors. In the present study, among patients with desmoid tumors who were prospectively and consecutively treated with identical conservative treatment with meloxicam, a selected patients of patients were treated with less invasive surgery than wide-resection. Out of 60 patients pathologically diagnosed with desmoid tumors, 9 patients with tumors refractory to conservative treatment and 4 patients who refused to receive this type of treatment were treated with planned simple resection. Subsequently, the clinical outcome of the patients and the mutational status of the catenin β-1 (CTNNB1) gene in the tumors were analyzed. The mean age of the 13 patients that underwent planned simple resection was 39 years, and the tumors were located in the abdominal wall in 6 cases, the chest wall in 4 cases and the neck in 3 cases. All excised specimens were evaluated and positive microscopic margins were identified; however, during the mean follow-up period of 30 months, 12/13 cases, 7 of which had T41A mutations and 5 of which had no mutations (wild-type), did not develop recurrence. Only 1 initial case with an S45F mutation in the CTNNB1 gene developed recurrence. The results of the present prospectively treated with simple resection and retrospectively analyzed study suggest that planned simple resection could serve as a therapeutic modality for extraperitoneal desmoid tumors, particularly truncal ones with a wild-type or T41A mutational status.

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“…Also, they spread along the fascial planes. A high local recurrence rate is reported in several studies (9)(10)(11)(12). Therefore, in the retrospective studies, radiotherapy (RT) has been suggested for its local control benefits.…”

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The Role of Radiotherapy in the Treatment of Primary or Recurrent Desmoid Tumors and Long-Term Results

et al. 2016

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Background: Desmoid tumors are uncommon and benign mesenchymal neoplasms. The optimal treatment of patients with desmoid tumors is still controversial. Surgery is the primary treatment for locally invasive or recurrent desmoid tumors. Also, radiotherapy is a treatment option for patients at high risk for local failure such as those with positive margins or recurrent and unresectable tumors. Aims: To report our institutional experience and longterm results of patients with desmoid tumors who received radiotherapy. Study Design: Retrospective cross-sectional study. Methods: Between 1980 and 2009, 20 patients who received radiotherapy (RT) in our institution were analyzed. The majority of patients (80%) were referred with a recurrent tumor after previous surgery. Thirteen patients underwent marginal resection, 4 had wide local excision and 3 patients had only biopsy. Resection margin was positive in 15 (75%) patients. All patients received radiation therapy. The median prescribed dose was 60 Gy. Five patients received less than 54 Gy. Results: The median follow-up time was 77.5 months (28-283 months). Nine patients developed local recurrence after RT. Seven local failures (78%) were in field. Time to local recurrence ranged from 3-165 months (median 33 months). The 2-5 year local control (LC) rates were 80% and 69%, respectively. On univariate analysis, the 5 year local control rate was significantly better in the patients treated with ≥54 Gy than in patients who received <54 Gy (p=0.023). The most common acute side effect was grade 1-2 skin toxicity. As a late side effect of radiotherapy, soft tissue fibrosis was detected in 10 patients and lymphangitis was seen in 1 patient. One patient developed radiation-induced sarcoma. Conclusion: According to our results, radiotherapy is especially effective in recurrent disease and provides a high local control rate in the patients received more than 54 Gy.

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Surgical treatment for local control of extremity and trunk desmoid tumors

Cited by 54 publications

References 22 publications

Low-dose chemotherapy with methotrexate and vinblastine for patients with desmoid tumors: relationship to CTNNB1 mutation status

Low-dose chemotherapy with methotrexate and vinblastine for patients with desmoid tumors: relationship to CTNNB1 mutation status

Simple resection of truncal desmoid tumors: A case series

The Role of Radiotherapy in the Treatment of Primary or Recurrent Desmoid Tumors and Long-Term Results

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