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

Research output: Contribution to journalArticlepeer-review

Authors

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

Colleges, School and Institutes

External organisations

  • Division of General and Laparoscopic Surgery, European Institute of Oncology, Milan, Italy. emilio.bertani@ieo.it

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.

Details

Original languageEnglish
Pages (from-to)184
JournalWorld Journal of Surgical Oncology
Volume10
Publication statusPublished - 10 Sep 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