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01.12.2012 | Research | Ausgabe 1/2012 Open Access

World Journal of Surgical Oncology 1/2012

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

Zeitschrift:
World Journal of Surgical Oncology > Ausgabe 1/2012
Autoren:
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
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1477-7819-10-184) contains supplementary material, which is available to authorized users.

Competing interests

All of the authors of this manuscript declared that no financial or non-financial interests were related to this study or future application after publication.

Authors’ contributions

EBe was responsible for manuscript writing and study design. AT, AC and RB gave comments and revised the manuscript. PM, EBo and BB were responsible for data acquisition and analysis. GV, GM and GC were in charge of correction of the manuscript, while TD, FV and BA collaborated on the whole project design. All authors read and approved the final manuscript.

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.
Zusatzmaterial
Authors’ original file for figure 1
12957_2012_1050_MOESM1_ESM.tiff
Authors’ original file for figure 2
12957_2012_1050_MOESM2_ESM.tiff
Authors’ original file for figure 3
12957_2012_1050_MOESM3_ESM.tiff
Literatur
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