Skip to main content
Erschienen in: Annals of Surgical Oncology 3/2021

01.01.2021 | Sarcoma

The Landmark Series: Desmoid

verfasst von: Marco Fiore, MD, FACS, Aimee Crago, MD, FACS, Rebecca Gladdy, MD, PhD, FRCSC, FACS, Bernd Kasper, MD, PhD

Erschienen in: Annals of Surgical Oncology | Ausgabe 3/2021

Einloggen, um Zugang zu erhalten

Abstract

Desmoid-type fibromatosis represents a challenge in the landscape of surgical oncology, for several reasons. The tumors can be infiltrative and locally aggressive, surgery may be morbid, and patients are usually young, and thus treatment sequelae must be managed for decades. Desmoids do not have metastatic potential, therefore management strategies for desmoids have evolved to employ frontline treatments that are largely non-operative. In fact, with unpredictable and benign behavior, we now recognize that desmoids can also stabilize and regress, making active observation an option for many patients. Moreover, many medical therapies are active in the disease. We reviewed landmark studies describing contemporary issues that affect treatment recommendations for desmoid patients: prognostic factors, indication to active surveillance, role of surgical margins, postoperative radiotherapy, and the most recent expert consensus papers.
Literatur
1.
Zurück zum Zitat WHO Classification of Tumours Editorial Board. Soft tissue and bone tumours. 5th Edition. Lyon: International Agency for Research on Cancer; 2020. WHO Classification of Tumours Editorial Board. Soft tissue and bone tumours. 5th Edition. Lyon: International Agency for Research on Cancer; 2020.
2.
Zurück zum Zitat Fiore M, Rimareix F, Mariani L et al. Desmoid-type fibromatosis: a front-line conservative approach to select patients for surgical treatment. Ann Surg Oncol 2009;16:2587–2593.PubMedCrossRef Fiore M, Rimareix F, Mariani L et al. Desmoid-type fibromatosis: a front-line conservative approach to select patients for surgical treatment. Ann Surg Oncol 2009;16:2587–2593.PubMedCrossRef
3.
Zurück zum Zitat Bonvalot S, Eldweny H, Haddad V et al. Extra-abdominal primary fibromatosis: Aggressive management could be avoided in a subgroup of patients. Eur J Surg Oncol 2008;34:462–468.PubMedCrossRef Bonvalot S, Eldweny H, Haddad V et al. Extra-abdominal primary fibromatosis: Aggressive management could be avoided in a subgroup of patients. Eur J Surg Oncol 2008;34:462–468.PubMedCrossRef
4.
Zurück zum Zitat Timbergen MJM, Schut AW, Grunhagen DJ, Sleijfer S, Verhoef C. Active surveillance in desmoid-type fibromatosis: a systematic literature review. Eur J Cancer 2020;137:18–29.PubMedCrossRef Timbergen MJM, Schut AW, Grunhagen DJ, Sleijfer S, Verhoef C. Active surveillance in desmoid-type fibromatosis: a systematic literature review. Eur J Cancer 2020;137:18–29.PubMedCrossRef
5.
Zurück zum Zitat Penel N, Le Cesne A, Bonvalot S et al. Surgical versus non-surgical approach in primary desmoid-type fibromatosis patients: a nationwide prospective cohort from the French Sarcoma Group. Eur J Cancer 2017;83:125–131.PubMedCrossRef Penel N, Le Cesne A, Bonvalot S et al. Surgical versus non-surgical approach in primary desmoid-type fibromatosis patients: a nationwide prospective cohort from the French Sarcoma Group. Eur J Cancer 2017;83:125–131.PubMedCrossRef
6.
Zurück zum Zitat Merchant NB, Lewis JJ, Woodruff JM, Leung DH, Brennan MF. Extremity and trunk desmoid tumors: a multifactorial analysis of outcome. Cancer 1999;86:2045–2052.PubMedCrossRef Merchant NB, Lewis JJ, Woodruff JM, Leung DH, Brennan MF. Extremity and trunk desmoid tumors: a multifactorial analysis of outcome. Cancer 1999;86:2045–2052.PubMedCrossRef
7.
Zurück zum Zitat Gronchi A, Casali PG, Mariani L et al. Quality of surgery and outcome in extra-abdominal aggressive fibromatosis: a series of patients surgically treated at a single institution. J Clin Oncol 2003;21:1390–1397.PubMedCrossRef Gronchi A, Casali PG, Mariani L et al. Quality of surgery and outcome in extra-abdominal aggressive fibromatosis: a series of patients surgically treated at a single institution. J Clin Oncol 2003;21:1390–1397.PubMedCrossRef
8.
Zurück zum Zitat Lev D, Kotilingam D, Wei C et al. Optimizing treatment of desmoid tumors. J Clin Oncol 2007;25:1785–1791.PubMedCrossRef Lev D, Kotilingam D, Wei C et al. Optimizing treatment of desmoid tumors. J Clin Oncol 2007;25:1785–1791.PubMedCrossRef
9.
Zurück zum Zitat Huang K, Fu H, Shi Y, Zhou Y, Du C. Prognostic factors for extra-abdominal and abdominal wall desmoids: A 20-year experience at a single institution. J Surg Oncol 2009;100:563–569.PubMedCrossRef Huang K, Fu H, Shi Y, Zhou Y, Du C. Prognostic factors for extra-abdominal and abdominal wall desmoids: A 20-year experience at a single institution. J Surg Oncol 2009;100:563–569.PubMedCrossRef
10.
Zurück zum Zitat Salas S, Dufresne A, Bui B et al. Prognostic factors influencing progression-free survival determined from a series of sporadic desmoid tumors: a wait-and-see policy according to tumor presentation. J Clin Oncol 2011;29:3553–3558.PubMedCrossRef Salas S, Dufresne A, Bui B et al. Prognostic factors influencing progression-free survival determined from a series of sporadic desmoid tumors: a wait-and-see policy according to tumor presentation. J Clin Oncol 2011;29:3553–3558.PubMedCrossRef
11.
Zurück zum Zitat Mullen JT, Delaney TF, Kobayashi WK et al. Desmoid tumor: analysis of prognostic factors and outcomes in a surgical series. Ann Surg Oncol 2012;19:4028–4035.PubMedCrossRef Mullen JT, Delaney TF, Kobayashi WK et al. Desmoid tumor: analysis of prognostic factors and outcomes in a surgical series. Ann Surg Oncol 2012;19:4028–4035.PubMedCrossRef
12.
13.
Zurück zum Zitat van Broekhoven DL, Verhoef C, Elias SG et al. Local recurrence after surgery for primary extra-abdominal desmoid-type fibromatosis. Br J Surg 2013;100:1214–1219.PubMedCrossRef van Broekhoven DL, Verhoef C, Elias SG et al. Local recurrence after surgery for primary extra-abdominal desmoid-type fibromatosis. Br J Surg 2013;100:1214–1219.PubMedCrossRef
14.
Zurück zum Zitat Cates JM, Stricker TP. Surgical resection margins in desmoid-type fibromatosis: a critical reassessment. Am J Surg Pathol 2014;38:1707–1714.PubMedCrossRef Cates JM, Stricker TP. Surgical resection margins in desmoid-type fibromatosis: a critical reassessment. Am J Surg Pathol 2014;38:1707–1714.PubMedCrossRef
15.
Zurück zum Zitat Janssen ML, van Broekhoven DL, Cates JM et al. Meta-analysis of the influence of surgical margin and adjuvant radiotherapy on local recurrence after resection of sporadic desmoid-type fibromatosis. Br J Surg 2017;104:347–357.PubMedCrossRef Janssen ML, van Broekhoven DL, Cates JM et al. Meta-analysis of the influence of surgical margin and adjuvant radiotherapy on local recurrence after resection of sporadic desmoid-type fibromatosis. Br J Surg 2017;104:347–357.PubMedCrossRef
16.
Zurück zum Zitat Baumert BG, Spahr MO, Von Hochstetter A et al. The impact of radiotherapy in the treatment of desmoid tumours. An international survey of 110 patients. A study of the Rare Cancer Network. Radiat Oncol 2007;2:12.PubMedPubMedCentralCrossRef Baumert BG, Spahr MO, Von Hochstetter A et al. The impact of radiotherapy in the treatment of desmoid tumours. An international survey of 110 patients. A study of the Rare Cancer Network. Radiat Oncol 2007;2:12.PubMedPubMedCentralCrossRef
17.
Zurück zum Zitat Bertani E, Testori A, Chiappa A et al. Recurrence and prognostic factors in patients with aggressive fibromatosis. The role of radical surgery and its limitations. World J Surg Oncol 2012;10:184.PubMedPubMedCentralCrossRef Bertani E, Testori A, Chiappa A et al. Recurrence and prognostic factors in patients with aggressive fibromatosis. The role of radical surgery and its limitations. World J Surg Oncol 2012;10:184.PubMedPubMedCentralCrossRef
18.
Zurück zum Zitat Eastley N, Aujla R, Silk R, Richards CJ, McCulloch TA, Esler CP, Ashford RU. Extra-abdominal desmoid fibromatosis–a sarcoma unit review of practice, long term recurrence rates and survival. Eur J Surg Oncol 2014;40:1125–1130.PubMedCrossRef Eastley N, Aujla R, Silk R, Richards CJ, McCulloch TA, Esler CP, Ashford RU. Extra-abdominal desmoid fibromatosis–a sarcoma unit review of practice, long term recurrence rates and survival. Eur J Surg Oncol 2014;40:1125–1130.PubMedCrossRef
19.
Zurück zum Zitat Ihalainen HR, Koljonen V, Bohling TO, Tukiainen EJ, Sampo MM. The desmoid tumour: local control after surgical treatment. J Plast Surg Hand Surg 2015;49:19–24.PubMedCrossRef Ihalainen HR, Koljonen V, Bohling TO, Tukiainen EJ, Sampo MM. The desmoid tumour: local control after surgical treatment. J Plast Surg Hand Surg 2015;49:19–24.PubMedCrossRef
20.
Zurück zum Zitat Kriz J, Eich HT, Haverkamp U, Seegenschmiedt MH, Heide J, Bruns F, Micke O. Radiotherapy is effective for desmoid tumors (aggressive fibromatosis)—long-term results of a German multicenter study. Oncol Res Treat 2014;37:255–260.PubMedCrossRef Kriz J, Eich HT, Haverkamp U, Seegenschmiedt MH, Heide J, Bruns F, Micke O. Radiotherapy is effective for desmoid tumors (aggressive fibromatosis)—long-term results of a German multicenter study. Oncol Res Treat 2014;37:255–260.PubMedCrossRef
21.
Zurück zum Zitat Pignatti G, Barbanti-Brodano G, Ferrari D et al. Extraabdominal desmoid tumor. A study of 83 cases. Clin Orthop Relat Res 2000;375:207–213.CrossRef Pignatti G, Barbanti-Brodano G, Ferrari D et al. Extraabdominal desmoid tumor. A study of 83 cases. Clin Orthop Relat Res 2000;375:207–213.CrossRef
22.
Zurück zum Zitat Prodinger PM, Rechl H, Keller M, Pilge H, Salzmann M, von Eisenhart-Rothe R, Holzapfel BM. Surgical resection and radiation therapy of desmoid tumours of the extremities: results of a supra-regional tumour centre. Int Orthop 2013;37:1987–1993.PubMedPubMedCentralCrossRef Prodinger PM, Rechl H, Keller M, Pilge H, Salzmann M, von Eisenhart-Rothe R, Holzapfel BM. Surgical resection and radiation therapy of desmoid tumours of the extremities: results of a supra-regional tumour centre. Int Orthop 2013;37:1987–1993.PubMedPubMedCentralCrossRef
23.
Zurück zum Zitat Stoeckle E, Coindre JM, Longy M et al. A critical analysis of treatment strategies in desmoid tumours: a review of a series of 106 cases. Eur J Surg Oncol 2009;35:129–134.PubMedCrossRef Stoeckle E, Coindre JM, Longy M et al. A critical analysis of treatment strategies in desmoid tumours: a review of a series of 106 cases. Eur J Surg Oncol 2009;35:129–134.PubMedCrossRef
24.
Zurück zum Zitat Wang CP, Chang YL, Ko JY, Cheng CH, Yeh CF, Lou PJ. Desmoid tumor of the head and neck. Head Neck 2006;28:1008–1013.PubMedCrossRef Wang CP, Chang YL, Ko JY, Cheng CH, Yeh CF, Lou PJ. Desmoid tumor of the head and neck. Head Neck 2006;28:1008–1013.PubMedCrossRef
25.
Zurück zum Zitat Wilkinson MJ, Chan KE, Hayes AJ, Strauss DC. Surgical outcomes following resection for sporadic abdominal wall fibromatosis. Ann Surg Oncol 2014;21:2144–2149.PubMedCrossRef Wilkinson MJ, Chan KE, Hayes AJ, Strauss DC. Surgical outcomes following resection for sporadic abdominal wall fibromatosis. Ann Surg Oncol 2014;21:2144–2149.PubMedCrossRef
26.
Zurück zum Zitat Desmoid Tumor Working Group. The management of desmoid tumours: a joint global consensus-based guideline approach for adult and paediatric patients. Eur J Cancer 2020;127:96–107.CrossRef Desmoid Tumor Working Group. The management of desmoid tumours: a joint global consensus-based guideline approach for adult and paediatric patients. Eur J Cancer 2020;127:96–107.CrossRef
27.
Zurück zum Zitat Keus RB, Nout RA, Blay JY, et al. Results of a phase II pilot study of moderate dose radiotherapy for inoperable desmoid-type fibromatosis: an EORTC STBSG and ROG study (EORTC 62991-22998). Ann Oncol 2013;24:2672–2676.PubMedCrossRef Keus RB, Nout RA, Blay JY, et al. Results of a phase II pilot study of moderate dose radiotherapy for inoperable desmoid-type fibromatosis: an EORTC STBSG and ROG study (EORTC 62991-22998). Ann Oncol 2013;24:2672–2676.PubMedCrossRef
28.
Zurück zum Zitat Crago AM, Chmielecki J, Rosenberg M et al. Near universal detection of alterations in CTNNB1 and Wnt pathway regulators in desmoid-type fibromatosis by whole-exome sequencing and genomic analysis. Genes Chromosomes Cancer 2015;54:606–615.PubMedPubMedCentralCrossRef Crago AM, Chmielecki J, Rosenberg M et al. Near universal detection of alterations in CTNNB1 and Wnt pathway regulators in desmoid-type fibromatosis by whole-exome sequencing and genomic analysis. Genes Chromosomes Cancer 2015;54:606–615.PubMedPubMedCentralCrossRef
29.
Zurück zum Zitat Lazar AJ, Tuvin D, Hajibashi S et al. Specific mutations in the beta-catenin gene (CTNNB1) correlate with local recurrence in sporadic desmoid tumors. Am J Pathol 2008;173:1518–1527.PubMedPubMedCentralCrossRef Lazar AJ, Tuvin D, Hajibashi S et al. Specific mutations in the beta-catenin gene (CTNNB1) correlate with local recurrence in sporadic desmoid tumors. Am J Pathol 2008;173:1518–1527.PubMedPubMedCentralCrossRef
31.
32.
Zurück zum Zitat Salas S, Chibon F, Noguchi T et al. Molecular characterization by array comparative genomic hybridization and DNA sequencing of 194 desmoid tumors. Genes Chromosomes Cancer 2010;49:560–568.PubMed Salas S, Chibon F, Noguchi T et al. Molecular characterization by array comparative genomic hybridization and DNA sequencing of 194 desmoid tumors. Genes Chromosomes Cancer 2010;49:560–568.PubMed
33.
Zurück zum Zitat Nishida Y, Tsukushi S, Urakawa H, Hamada S, Kozawa E, Ikuta K, et al. Simple resection of truncal desmoid tumors: a case series. Oncol Lett 2016; 12:1564–1568.PubMedPubMedCentralCrossRef Nishida Y, Tsukushi S, Urakawa H, Hamada S, Kozawa E, Ikuta K, et al. Simple resection of truncal desmoid tumors: a case series. Oncol Lett 2016; 12:1564–1568.PubMedPubMedCentralCrossRef
34.
35.
Zurück zum Zitat Mussi CE, Colombo P, Lo Russo C et al. Sporadic desmoid tumors of the abdominal wall: the results of surgery. Tumori 2016;102:582–587.PubMedCrossRef Mussi CE, Colombo P, Lo Russo C et al. Sporadic desmoid tumors of the abdominal wall: the results of surgery. Tumori 2016;102:582–587.PubMedCrossRef
36.
Zurück zum Zitat van Broekhoven DL, Verhoef C, Grunhagen DJ et al. Prognostic value of CTNNB1 gene mutation in primary sporadic aggressive fibromatosis. Ann Surg Oncol 2015;22:1464–1470.PubMedCrossRef van Broekhoven DL, Verhoef C, Grunhagen DJ et al. Prognostic value of CTNNB1 gene mutation in primary sporadic aggressive fibromatosis. Ann Surg Oncol 2015;22:1464–1470.PubMedCrossRef
37.
Zurück zum Zitat Colombo C, Miceli R, Lazar AJ et al. CTNNB1 45F mutation is a molecular prognosticator of increased postoperative primary desmoid tumor recurrence: an independent, multicenter validation study. Cancer 2013;119:3696–3702.PubMedCrossRef Colombo C, Miceli R, Lazar AJ et al. CTNNB1 45F mutation is a molecular prognosticator of increased postoperative primary desmoid tumor recurrence: an independent, multicenter validation study. Cancer 2013;119:3696–3702.PubMedCrossRef
38.
Zurück zum Zitat Heinrich MC, McArthur GA, Demetri GD et al. Clinical and molecular studies of the effect of imatinib on advanced aggressive fibromatosis (desmoid tumor). J Clin Oncol 2006;24:1195–1203.PubMedCrossRef Heinrich MC, McArthur GA, Demetri GD et al. Clinical and molecular studies of the effect of imatinib on advanced aggressive fibromatosis (desmoid tumor). J Clin Oncol 2006;24:1195–1203.PubMedCrossRef
39.
Zurück zum Zitat Penel N, Le Cesne A, Bui BN et al. Imatinib for progressive and recurrent aggressive fibromatosis (desmoid tumors): an FNCLCC/French Sarcoma Group phase II trial with a long-term follow-up. Ann Oncol 2011;22:452–457.PubMedCrossRef Penel N, Le Cesne A, Bui BN et al. Imatinib for progressive and recurrent aggressive fibromatosis (desmoid tumors): an FNCLCC/French Sarcoma Group phase II trial with a long-term follow-up. Ann Oncol 2011;22:452–457.PubMedCrossRef
40.
Zurück zum Zitat Kasper B, Gruenwald V, Reichardt P et al. Imatinib induces sustained progression arrest in RECIST progressive desmoid tumours: final results of a phase II study of the German Interdisciplinary Sarcoma Group (GISG). Eur J Cancer 2017;76:60–67.PubMedCrossRef Kasper B, Gruenwald V, Reichardt P et al. Imatinib induces sustained progression arrest in RECIST progressive desmoid tumours: final results of a phase II study of the German Interdisciplinary Sarcoma Group (GISG). Eur J Cancer 2017;76:60–67.PubMedCrossRef
41.
Zurück zum Zitat Toulmonde M, Pulido M, Ray-Coquard I et al. Pazopanib or methotrexate-vinblastine combination chemotherapy in adult patients with progressive desmoid tumours (DESMOPAZ): a non-comparative, randomised, open-label, multicentre, phase 2 study. Lancet Oncol 2019;20:1263–1272.PubMedCrossRef Toulmonde M, Pulido M, Ray-Coquard I et al. Pazopanib or methotrexate-vinblastine combination chemotherapy in adult patients with progressive desmoid tumours (DESMOPAZ): a non-comparative, randomised, open-label, multicentre, phase 2 study. Lancet Oncol 2019;20:1263–1272.PubMedCrossRef
42.
44.
Zurück zum Zitat Gronchi A, Colombo C, Le Pechoux C et al. Sporadic desmoid-type fibromatosis: a stepwise approach to a non-metastasising neoplasm: a position paper from the Italian and the French Sarcoma Group. Ann Oncol 2014;25:578–583.PubMedCrossRef Gronchi A, Colombo C, Le Pechoux C et al. Sporadic desmoid-type fibromatosis: a stepwise approach to a non-metastasising neoplasm: a position paper from the Italian and the French Sarcoma Group. Ann Oncol 2014;25:578–583.PubMedCrossRef
45.
Zurück zum Zitat Kasper B, Baumgarten C, Bonvalot S et al. Management of sporadic desmoid-type fibromatosis: a European consensus approach based on patients’ and professionals’ expertise—a sarcoma patients EuroNet and European Organisation for Research and Treatment of Cancer/Soft Tissue and Bone Sarcoma Group initiative. Eur J Cancer 2015;51:127–136.PubMedCrossRef Kasper B, Baumgarten C, Bonvalot S et al. Management of sporadic desmoid-type fibromatosis: a European consensus approach based on patients’ and professionals’ expertise—a sarcoma patients EuroNet and European Organisation for Research and Treatment of Cancer/Soft Tissue and Bone Sarcoma Group initiative. Eur J Cancer 2015;51:127–136.PubMedCrossRef
46.
Zurück zum Zitat Kasper B, Baumgarten C, Garcia J et al. An update on the management of sporadic desmoid-type fibromatosis: a European Consensus Initiative between Sarcoma PAtients EuroNet (SPAEN) and European Organization for Research and Treatment of Cancer (EORTC)/Soft Tissue and Bone Sarcoma Group (STBSG). Ann Oncol 2017;28:2399–2408.PubMedPubMedCentralCrossRef Kasper B, Baumgarten C, Garcia J et al. An update on the management of sporadic desmoid-type fibromatosis: a European Consensus Initiative between Sarcoma PAtients EuroNet (SPAEN) and European Organization for Research and Treatment of Cancer (EORTC)/Soft Tissue and Bone Sarcoma Group (STBSG). Ann Oncol 2017;28:2399–2408.PubMedPubMedCentralCrossRef
47.
Zurück zum Zitat Penel N, Coindre JM, Bonvalot S et al. Management of desmoid tumours: a nationwide survey of labelled reference centre networks in France. Eur J Cancer 2016;58:90–96.PubMedCrossRef Penel N, Coindre JM, Bonvalot S et al. Management of desmoid tumours: a nationwide survey of labelled reference centre networks in France. Eur J Cancer 2016;58:90–96.PubMedCrossRef
48.
Zurück zum Zitat van Broekhoven DL, Deroose JP, Bonvalot S, Gronchi A, Grunhagen DJ, Eggermont AM, et al. Isolated limb perfusion using tumour necrosis factor alpha and melphalan in patients with advanced aggressive fibromatosis. Br J Surg 2014;101:1674–1680.PubMedCrossRef van Broekhoven DL, Deroose JP, Bonvalot S, Gronchi A, Grunhagen DJ, Eggermont AM, et al. Isolated limb perfusion using tumour necrosis factor alpha and melphalan in patients with advanced aggressive fibromatosis. Br J Surg 2014;101:1674–1680.PubMedCrossRef
49.
Zurück zum Zitat Gounder MM, Maddux L, Paty J, Atkinson TM. Prospective development of a patient-reported outcomes instrument for desmoid tumors or aggressive fibromatosis. Cancer 2020;126:531–539.PubMedCrossRef Gounder MM, Maddux L, Paty J, Atkinson TM. Prospective development of a patient-reported outcomes instrument for desmoid tumors or aggressive fibromatosis. Cancer 2020;126:531–539.PubMedCrossRef
50.
Zurück zum Zitat Orbach D, Brennan B, Bisogno G et al. The EpSSG NRSTS 2005 treatment protocol for desmoid-type fibromatosis in children: an international prospective case series. Lancet Child Adolesc Health 2017;1:284–292.PubMedCrossRef Orbach D, Brennan B, Bisogno G et al. The EpSSG NRSTS 2005 treatment protocol for desmoid-type fibromatosis in children: an international prospective case series. Lancet Child Adolesc Health 2017;1:284–292.PubMedCrossRef
51.
Zurück zum Zitat Skapek SX, Anderson JR, Hill DA et al. Safety and efficacy of high-dose tamoxifen and sulindac for desmoid tumor in children: results of a Children’s Oncology Group (COG) phase II study. Pediatr Blood Cancer 2013;60:1108–1112.PubMedCrossRef Skapek SX, Anderson JR, Hill DA et al. Safety and efficacy of high-dose tamoxifen and sulindac for desmoid tumor in children: results of a Children’s Oncology Group (COG) phase II study. Pediatr Blood Cancer 2013;60:1108–1112.PubMedCrossRef
52.
Zurück zum Zitat Fiore M, Coppola S, Cannell AJ et al. Desmoid-type fibromatosis and pregnancy: a multi-institutional analysis of recurrence and obstetric risk. Ann Surg 2014;259:973–978.PubMedCrossRef Fiore M, Coppola S, Cannell AJ et al. Desmoid-type fibromatosis and pregnancy: a multi-institutional analysis of recurrence and obstetric risk. Ann Surg 2014;259:973–978.PubMedCrossRef
53.
Zurück zum Zitat Improta L, Tzanis D, Bouhadiba T, Abdelhafidh K, Bonvalot S. Desmoid tumours in the surveillance era: what are the remaining indications for surgery? Eur J Surg Oncol 2020;46:1310–1314.PubMedCrossRef Improta L, Tzanis D, Bouhadiba T, Abdelhafidh K, Bonvalot S. Desmoid tumours in the surveillance era: what are the remaining indications for surgery? Eur J Surg Oncol 2020;46:1310–1314.PubMedCrossRef
Metadaten
Titel
The Landmark Series: Desmoid
verfasst von
Marco Fiore, MD, FACS
Aimee Crago, MD, FACS
Rebecca Gladdy, MD, PhD, FRCSC, FACS
Bernd Kasper, MD, PhD
Publikationsdatum
01.01.2021
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 3/2021
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-020-09395-5

Weitere Artikel der Ausgabe 3/2021

Annals of Surgical Oncology 3/2021 Zur Ausgabe

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 Ablationstherapie Nachrichten

Nach der Katheterablation von Vorhofflimmern kommt es bei etwa einem Drittel der Patienten zu Rezidiven, meist binnen eines Jahres. Wie sich spätere Rückfälle auf die Erfolgschancen einer erneuten Ablation auswirken, haben Schweizer Kardiologen erforscht.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

23.04.2024 Operationsvorbereitung Nachrichten

Derzeit wird empfohlen, eine Therapie mit GLP-1-Rezeptoragonisten präoperativ zu unterbrechen. Eine neue Studie nährt jedoch Zweifel an der Notwendigkeit der Maßnahme.

Ureterstriktur: Innovative OP-Technik bewährt sich

19.04.2024 EAU 2024 Kongressbericht

Die Ureterstriktur ist eine relativ seltene Komplikation, trotzdem bedarf sie einer differenzierten Versorgung. In komplexen Fällen wird dies durch die roboterassistierte OP-Technik gewährleistet. Erste Resultate ermutigen.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.