Recurrence and prognostic factors in patients with aggressive fibromatosis. The role of radical surgery and its limitations

Emilio Bertani; Alessandro Testori; Antonio Chiappa; Pasquale Misitano; Roberto Biffi; Giuseppe Viale; Giovanni Mazzarol; Tommaso De Pas; Edoardo Botteri; Gianmarco Contino; Francesco Verrecchia; Barbara Bazolli; Bruno Andreoni

doi:10.1186/1477-7819-10-184

Recurrence and prognostic factors in patients with aggressive fibromatosis. The role of radical surgery and its limitations

Emilio Bertani, Alessandro Testori, Antonio Chiappa, Pasquale Misitano, Roberto Biffi, Giuseppe Viale, Giovanni Mazzarol, Tommaso De Pas, Edoardo Botteri, Gianmarco Contino, Francesco Verrecchia, Barbara Bazolli, Bruno Andreoni

Cancer and Genomic Sciences

Research output: Contribution to journal › Article › peer-review

27 Citations (Scopus)

Abstract

BACKGROUND: Surgery is still the standard treatment for aggressive fibromatosis (AF); however, local control remains a significant problem and the impact of R0 surgery on cumulative recurrence (CR) is objective of contradictory reports.

METHODS: This is a single-institution study of 62 consecutive patients affected by extra-abdominal and intra-abdominal AF who received macroscopically radical surgery within a time period of 15 years.

RESULTS: Definitive pathology examination confirmed an R0 situation in 49 patients and an R1 in 13 patients. Five-year CR for patients who underwent R0 vs R1 surgery was 7.1% vs 46.4% (P = 0.04) and for limbs vs other localizations 33.3% vs 9.9% (P = 0.02) respectively. In 17 patients who had intraoperative frozen section (IFS) margin evaluation R0 surgery was more common (17 of 17 vs 32 of 45, P = 0.01) and CR lower (five-year CR 0% vs 19.1%, respectively, P = 0.04). However, in multivariate analysis only limb localization showed a negative impact on CR (HR: 1.708, 95% CI 1.03 to 2.84, P = 0.04).

CONCLUSIONS: IFS evaluation could help the surgeon to achieve R0 surgery in AF. Non-surgical treatment, including watchful follow-up, could be indicated for patients with limb AF localization, because of their high risk of recurrence even after R0 surgery.

Original language	English
Pages (from-to)	184
Journal	World Journal of Surgical Oncology
Volume	10
DOIs	https://doi.org/10.1186/1477-7819-10-184
Publication status	Published - 10 Sept 2012

Keywords

Adolescent
Adult
Aged
Female
Fibromatosis, Aggressive/mortality
Follow-Up Studies
Humans
Male
Middle Aged
Neoplasm Recurrence, Local/diagnosis
Neoplasm Staging
Neoplasm, Residual/diagnosis
Prognosis
Remission Induction
Risk Factors
Survival Rate
Young Adult

Access to Document

10.1186/1477-7819-10-184

Cite this

Bertani, E., Testori, A., Chiappa, A., Misitano, P., Biffi, R., Viale, G., Mazzarol, G., De Pas, T., Botteri, E., Contino, G., Verrecchia, F., Bazolli, B., & Andreoni, B. (2012). Recurrence and prognostic factors in patients with aggressive fibromatosis. The role of radical surgery and its limitations. World Journal of Surgical Oncology, 10, 184. https://doi.org/10.1186/1477-7819-10-184

@article{2c97477cda61406d8247e0b3abb27dfa,

title = "Recurrence and prognostic factors in patients with aggressive fibromatosis. The role of radical surgery and its limitations",

abstract = "BACKGROUND: Surgery is still the standard treatment for aggressive fibromatosis (AF); however, local control remains a significant problem and the impact of R0 surgery on cumulative recurrence (CR) is objective of contradictory reports.METHODS: This is a single-institution study of 62 consecutive patients affected by extra-abdominal and intra-abdominal AF who received macroscopically radical surgery within a time period of 15 years.RESULTS: Definitive pathology examination confirmed an R0 situation in 49 patients and an R1 in 13 patients. Five-year CR for patients who underwent R0 vs R1 surgery was 7.1% vs 46.4% (P = 0.04) and for limbs vs other localizations 33.3% vs 9.9% (P = 0.02) respectively. In 17 patients who had intraoperative frozen section (IFS) margin evaluation R0 surgery was more common (17 of 17 vs 32 of 45, P = 0.01) and CR lower (five-year CR 0% vs 19.1%, respectively, P = 0.04). However, in multivariate analysis only limb localization showed a negative impact on CR (HR: 1.708, 95% CI 1.03 to 2.84, P = 0.04).CONCLUSIONS: IFS evaluation could help the surgeon to achieve R0 surgery in AF. Non-surgical treatment, including watchful follow-up, could be indicated for patients with limb AF localization, because of their high risk of recurrence even after R0 surgery.",

keywords = "Adolescent, Adult, Aged, Female, Fibromatosis, Aggressive/mortality, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasm Recurrence, Local/diagnosis, Neoplasm Staging, Neoplasm, Residual/diagnosis, Prognosis, Remission Induction, Risk Factors, Survival Rate, Young Adult",

author = "Emilio Bertani and Alessandro Testori and Antonio Chiappa and Pasquale Misitano and Roberto Biffi and Giuseppe Viale and Giovanni Mazzarol and {De Pas}, Tommaso and Edoardo Botteri and Gianmarco Contino and Francesco Verrecchia and Barbara Bazolli and Bruno Andreoni",

year = "2012",

month = sep,

day = "10",

doi = "10.1186/1477-7819-10-184",

language = "English",

volume = "10",

pages = "184",

journal = "World Journal of Surgical Oncology",

issn = "1477-7819",

publisher = "Springer",

}

Bertani, E, Testori, A, Chiappa, A, Misitano, P, Biffi, R, Viale, G, Mazzarol, G, De Pas, T, Botteri, E, Contino, G, Verrecchia, F, Bazolli, B & Andreoni, B 2012, 'Recurrence and prognostic factors in patients with aggressive fibromatosis. The role of radical surgery and its limitations', World Journal of Surgical Oncology, vol. 10, pp. 184. https://doi.org/10.1186/1477-7819-10-184

TY - JOUR

T1 - Recurrence and prognostic factors in patients with aggressive fibromatosis. The role of radical surgery and its limitations

AU - Bertani, Emilio

AU - Testori, Alessandro

AU - Chiappa, Antonio

AU - Misitano, Pasquale

AU - Biffi, Roberto

AU - Viale, Giuseppe

AU - Mazzarol, Giovanni

AU - De Pas, Tommaso

AU - Botteri, Edoardo

AU - Contino, Gianmarco

AU - Verrecchia, Francesco

AU - Bazolli, Barbara

AU - Andreoni, Bruno

PY - 2012/9/10

Y1 - 2012/9/10

N2 - BACKGROUND: Surgery is still the standard treatment for aggressive fibromatosis (AF); however, local control remains a significant problem and the impact of R0 surgery on cumulative recurrence (CR) is objective of contradictory reports.METHODS: This is a single-institution study of 62 consecutive patients affected by extra-abdominal and intra-abdominal AF who received macroscopically radical surgery within a time period of 15 years.RESULTS: Definitive pathology examination confirmed an R0 situation in 49 patients and an R1 in 13 patients. Five-year CR for patients who underwent R0 vs R1 surgery was 7.1% vs 46.4% (P = 0.04) and for limbs vs other localizations 33.3% vs 9.9% (P = 0.02) respectively. In 17 patients who had intraoperative frozen section (IFS) margin evaluation R0 surgery was more common (17 of 17 vs 32 of 45, P = 0.01) and CR lower (five-year CR 0% vs 19.1%, respectively, P = 0.04). However, in multivariate analysis only limb localization showed a negative impact on CR (HR: 1.708, 95% CI 1.03 to 2.84, P = 0.04).CONCLUSIONS: IFS evaluation could help the surgeon to achieve R0 surgery in AF. Non-surgical treatment, including watchful follow-up, could be indicated for patients with limb AF localization, because of their high risk of recurrence even after R0 surgery.

AB - BACKGROUND: Surgery is still the standard treatment for aggressive fibromatosis (AF); however, local control remains a significant problem and the impact of R0 surgery on cumulative recurrence (CR) is objective of contradictory reports.METHODS: This is a single-institution study of 62 consecutive patients affected by extra-abdominal and intra-abdominal AF who received macroscopically radical surgery within a time period of 15 years.RESULTS: Definitive pathology examination confirmed an R0 situation in 49 patients and an R1 in 13 patients. Five-year CR for patients who underwent R0 vs R1 surgery was 7.1% vs 46.4% (P = 0.04) and for limbs vs other localizations 33.3% vs 9.9% (P = 0.02) respectively. In 17 patients who had intraoperative frozen section (IFS) margin evaluation R0 surgery was more common (17 of 17 vs 32 of 45, P = 0.01) and CR lower (five-year CR 0% vs 19.1%, respectively, P = 0.04). However, in multivariate analysis only limb localization showed a negative impact on CR (HR: 1.708, 95% CI 1.03 to 2.84, P = 0.04).CONCLUSIONS: IFS evaluation could help the surgeon to achieve R0 surgery in AF. Non-surgical treatment, including watchful follow-up, could be indicated for patients with limb AF localization, because of their high risk of recurrence even after R0 surgery.

KW - Adolescent

KW - Adult

KW - Aged

KW - Female

KW - Fibromatosis, Aggressive/mortality

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Middle Aged

KW - Neoplasm Recurrence, Local/diagnosis

KW - Neoplasm Staging

KW - Neoplasm, Residual/diagnosis

KW - Prognosis

KW - Remission Induction

KW - Risk Factors

KW - Survival Rate

KW - Young Adult

U2 - 10.1186/1477-7819-10-184

DO - 10.1186/1477-7819-10-184

M3 - Article

C2 - 22963172

SN - 1477-7819

VL - 10

SP - 184

JO - World Journal of Surgical Oncology

JF - World Journal of Surgical Oncology

ER -

Recurrence and prognostic factors in patients with aggressive fibromatosis. The role of radical surgery and its limitations

Abstract

Keywords

Access to Document

Fingerprint

Cite this