Conservative management of desmoid tumors is safe and effective

Jiwon Sarah Park, Yves Paul Nakache, Jeremy Katz, Robert D Boutin, Robert J. Steffner, Arta M Monjazeb, Robert J Canter

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Background Surgical resection of desmoid tumors has traditionally been the mainstay of therapy, but this is a potentially morbid approach with high rates of recurrence. Given increasing reports of active surveillance in this disease, we sought to evaluate our experience with conservative management hypothesizing this would be an effective strategy. Materials and methods Using a prospectively maintained database of sarcoma patients from 2008 to 2015, we identified 47 patients with a diagnosis of desmoid tumor from all anatomic sites. Data points were abstracted on clinical and pathologic factors, disease stability or progression, and follow-up time. Main outcome measurements were tumor recurrence after surgical resection versus tumor progression with conservative management. Results In our cohort, 20 patients were managed with surveillance, 24 patients with surgery, and three patients with other approaches. Clinical and tumor characteristics between treatment groups were not significantly different. With a median follow-up of 35.7 mo, there was one complete regression, five partial regressions, and 13 stable diseases among the surveillance group. Only one patient under observation progressed, crossing over to surgical resection. Among 24 patients managed with surgery, 13 patients developed local recurrence. Kaplan–Meier analysis revealed a statistically superior progression-free survival in the surveillance group (P = 0.001). Conclusions This retrospective analysis adds to the growing body of evidence that observation of desmoid tumors is safe and effective with high rates of stable disease. These data further support an initial conservative approach to desmoid tumors that may spare patients the morbidity and risk of recurrence that accompanies potentially extensive operations.

Original languageEnglish (US)
Pages (from-to)115-120
Number of pages6
JournalJournal of Surgical Research
Volume205
Issue number1
DOIs
StatePublished - Sep 1 2016

Keywords

  • Desmoid tumors
  • Medical management
  • Observation
  • Recurrence
  • Surgery

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

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