Upfront surgery is not advantageous compared to more conservative treatments such as observation or medical treatment for patients with desmoid tumors

Abstract

Background This study compared the clinical and functional outcomes of patients initially treated with observation or medical treatment with those of patients treated with local treatment (surgery alone or surgery with adjuvant radiotherapy) to confirm whether observation or medical treatment is an appropriate first-line management approach for patients with desmoid tumors. Methods We retrospectively reviewed the medical records of 99 patients with histologically confirmed primary desmoid tumors treated between 1978 and 2018. The median follow-up period was 57 months. We evaluated event-free survival, defined as the time interval from the date of initial diagnosis to the date of specific change in treatment strategy or recurrence or the last follow-up. Results An event (specific change in treatment strategy or recurrence) occurred in 28 patients (28.3%). No significant difference in event-free survival was found between the first-line observation/medical treatment and local treatment groups (p = 0.509). The median Musculoskeletal Tumor Society score of the patients treated with first-line local treatment was 29 (interquartile range [IQR], 23–30), whereas that of the patients managed with first-line observation or medical treatment was 21 (IQR, 19–29.5). First-line observation or medical treatment was more frequently chosen for larger tumors (p = 0.045). In the patients treated with local treatment, local recurrence was not related to the surgical margin (p = 0.976). Conclusion Upfront surgery is not advantageous compared to more conservative treatments such as observation or medical treatment for patients with desmoid tumors.

Clinical features and ultrasound findings of a rare musculoskeletal system disease–neuromuscular choristoma

“…In the subset of our tumor surgery group, all 5 patients presented with progression of NMC-DTFs at the site of the NMCs. Previous studies supported that the mainstay of treatment for NMC-associated DTF could be nonsurgical management including locoregional chemotherapy, exclusive radiation, systemic chemotherapy, and/or targeted therapy [ 23 , 26 ]. Further study may be needed to identify the best treatment of NMC-DTF.…”

Desmoid Tumor in a pregnant pacient´s breast. Case report

“…Por esta razón para el tratamiento del tumor desmoide se ha seguido últimamente una estrategia más conservadora, con observación del tumor, control con métodos de imagen, y si se presenta progresión se evalúa el uso de quimioterapia, radioterapia o resección quirúrgica (7) En el caso de esta paciente, el tratamiento quirúrgico se realizó teniendo en cuenta que la resección de tumor de cuadrante supero externo de mama del lado derecho no traería alteraciones estéticas, ni funcionales importantes para la paciente y además de que se trataba de una paciente gestante, de siete semanas.…”

Mesenteric desmoid tumor: De novo occurrence or recurrence following appendectomy?

“…Classically treatment has consisted of early surgery due to the locally invasive risks of DF and/or desmoid tumors. Yet recent evidence shows that a multidisciplinary approach with more conservative options may have better outcomes, to include watchful waiting [9] . Other treatment options include systemic therapy in the form of antiestrogen therapy and NSAIDs, Tamoxifen, and Sulindac.…”