Aggressive fibromatosis: treatment modalities and results | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 21, Issue 2, April 2002, Page 890-894 PDF (2.74 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejsur.2002.402436 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Sherif I. Maamoun* 1; Samy R. Shehata1; Tarek Essam1; Manal M. El-Baradie2 | ||||
| 1Surgical Oncology, National Cancer Institute, Cairo University | ||||
| 2Radiation Therapy, National Cancer Institute, Cairo University | ||||
| Abstract | ||||
| Aggressive fibromatosis are rare neoplasms with unpredictable behavior and high local relapse rate following surgical resection. This, together with the lack of large randomized trials, have resulted in much debate in evaluation of alternative therapeutic intervention. We have reviewed our results of treatment of these lesions in an attempt to define guidelines of treatment and patterns of failure. Material and Methods: We reviewed the records of 149 patients diagnosed as aggressive fibromatosis in our institute between January 1992 and January 2001. Twelve records were discarded due to incomplete data thus leaving 137 records for evaluation (89 females, 48 males; mean age 26.4 years). Patients were divided into two groups according to the treatment modality; surgery alone group and combined surgery and radiation therapy group. Evaluation included local control rates and analysis of failure as regards therapeutic modality used, margin status, and presentation status (primary or recurrent). Results: Ninety eight patients were treated with surgery alone. The initial local control rate was 62.2% with a median time to recurrence of 25.4 months. Thirty nine patients received adjuvant radiation therapy with a local control rate of 82.1%. The difference in the local control rates between the two groups was statistically significant (p = 0.014). Margin status was the most important predictor of failure. The local recurrence rates for positive and close margins (<0.5 cm) were 50% and 40.9% respectively in the surgery alone group. Previous recurrence had a significant negative impact on patients' outcome. The local control rates for primary and recurrent cases were 75.6% and 46.8% respectively. Conclusion: Surgical resection with wide safety margin whenever feasible is the appropriate initial therapy for these group of lesions. In case, wide margins could not be achieved and for recurrent disease, the addition of radiation therapy will improve the final outcome of these patients. | ||||
| Keywords | ||||
| Aggressive fibromatosis; Desmoid tumor | ||||
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