Wait-and-See Policy as a First-Line Management for Extra-Abdominal Desmoid Tumors

Briand, Sylvain; Barbier, Olivier; Biau, David; Bertrand-Vasseur, A.; Larousserie, Frédérique; Anract, Philippe; Gouin, F.

doi:10.2106/jbjs.m.00988

Cited by 84 publications

(68 citation statements)

References 36 publications

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“…The characteristic feature of these tumors is that they behave in a very unpredictable manner. They may remain stable, grow aggressively, or even regress by themselves …”

Section: Introductionmentioning

confidence: 99%

Comparison of sporadic and FAP‐associated desmoid‐type fibromatoses

Koskenvuo

Ristimäki

Lepistö

2017

Journal of Surgical Oncology

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The predictors for FAP occurrence among desmoid tumor patients are large tumor size, intra-abdominal location, multiple tumors, and patient's young age. Desmoid-type fibromatosis patients suffer a high recurrence rate, also among those experiencing sporadic tumors, but the risk of death due to the tumor is low. Conversely, desmoid disease represents a substantial cause of death among FAP patients.

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“…The characteristic feature of these tumors is that they behave in a very unpredictable manner. They may remain stable, grow aggressively, or even regress by themselves …”

Section: Introductionmentioning

confidence: 99%

Comparison of sporadic and FAP‐associated desmoid‐type fibromatoses

Koskenvuo

Ristimäki

Lepistö

2017

Journal of Surgical Oncology

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“…Considering these enigmatic behaviors, the therapeutic approach for extra-peritoneal DF has been shifting from surgery with a wide surgical margin to conservative therapy [7, 8]. Recently, several therapeutic modalities for DF were reported including ‘wait & see’ only [9], COX-2 inhibitor therapy [10], hormonal therapy [11], low-dose chemotherapy [12], and tyrosine kinase inhibitors [13, 14], while few studies have investigated the prognosticators of these conservative therapies thus far.…”

Section: Introductionmentioning

confidence: 99%

Immunohistochemical staining with non-phospho β-catenin as a diagnostic and prognostic tool of COX-2 inhibitor therapy for patients with extra-peritoneal desmoid-type fibromatosis

et al. 2017

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BackgroundImmunohistochemical staining with conventional anti-β-catenin antibody has been applied as a diagnostic tool for desmoid-type fibromatosis (DF). This study aimed to evaluate the diagnostic and prognostic value of immunohistochemical staining with anti-non-phospho β-catenin antibody, which might more accurately reflect the aggressiveness of DF, in comparison to the conventional anti-β-catenin antibody.MethodsBetween 2003 and 2015, 40 patients with extra-peritoneal sporadic DF were prospectively treated with meloxicam or celecoxib, a COX-2 inhibitor, therapy. The efficacy of this treatment was evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST). Immunohistochemical staining was performed on formalin-fixed material to evaluate the expression of β-catenin and non-phospho β-catenin, and the positivity was grouped as negative, weak, moderate, and strong. DNA was isolated from frozen tissue or formalin-fixed materials, and the CTNNB1 mutation status was determined by direct sequencing.ResultsOf the 40 patients receiving COX-2 inhibitor treatment, there was one with complete remission, 12 with partial remission, 7 with stable disease, and 20 with progressive disease. The mutation sites in CTNNB1 were detected in 22 (55%) of the 40 cases: T41A (17 cases), S45F (3 cases), and T41I and S45P (1 each). The positive nuclear expression of non-phospho β-catenin showed a significant correlation with positive CTNNB1 mutation status detected by Sanger method (p = 0.025), and poor outcome in COX-2 inhibitor therapy (p = 0.022). In contrast, nuclear expression of β-catenin did not show a significant correlation with either CTNNB1 mutation status (p = 0.43) or outcome of COX-2 inhibitor therapy (p = 0.38).ConclusionsNuclear expression of non-phospho β-catenin might more appropriately reflect the biological behavior of DF, and immunohistochemical staining with non-phospho β-catenin could serve as a more useful diagnostic and prognostic tool of COX-2 inhibitor therapy for patients with DF.

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“…The potential morbidity associated with surgery and radiotherapy and a high recurrence rate even after radical surgery have led investigators to assess the role of a wait-and-see policy [8,13,14] in desmoid tumor treatment, as well as the roles of noncytotoxic [15,16] and cytotoxic [17,18] chemotherapy. Because extra-abdominal desmoid tumors do not metastasize and rarely cause disease-specific death, medical treatment with fewer complications is desirable.…”

Section: Introductionmentioning

confidence: 99%