Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-12-01T07:18:57.099Z Has data issue: false hasContentIssue false
  • English
  • Français

Radiotherapy in desmoid fibromatosis: a 10-year experience from a tertiary care centre

Published online by Cambridge University Press:  13 November 2019

Sunitha S. Varghese Open the ORCID record for Sunitha S. Varghese [Opens in a new window] ,
Sharief Sidhique ,
Anne J. Prabhu ,
Simon P. Pavamani ,
B. Antonysamy ,
Vijay T. K. Titus ,
Sukriya Nayak  and
Selvamani Backianathan
Sunitha S. Varghese*
Affiliation:
Department of Radiation Oncology, Christian Medical College, Vellore, Tamil Nadu, India
Sharief Sidhique
Affiliation:
Department of Radiation Oncology, Christian Medical College, Vellore, Tamil Nadu, India
Anne J. Prabhu
Affiliation:
Department of Pathology, Christian Medical College, Vellore, Tamil Nadu, India
Simon P. Pavamani
Affiliation:
Department of Radiation Oncology, Christian Medical College, Vellore, Tamil Nadu, India
B. Antonysamy
Affiliation:
Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
Vijay T. K. Titus
Affiliation:
Department of Orthopedics, Christian Medical College, Vellore, Tamil Nadu, India
Sukriya Nayak
Affiliation:
Department of General Surgery, Christian Medical College, Vellore, Tamil Nadu, India
Selvamani Backianathan
Affiliation:
Department of Radiation Oncology, Christian Medical College, Vellore, Tamil Nadu, India
*
Author for correspondence: Sunitha Susan Varghese, Christian Medical College and Hospital Vellore, Vellore 632004, India. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim of the study:

To assess the relapse-free survival (RFS) and the factors influencing local recurrence in patients with desmoid fibromatosis (DF) treated at our centre and to determine the role of post-operative radiotherapy (RT) in improving local control.

Methods:

A retrospective analysis of 51 patients treated for DF from January 2004 to December 2013 was undertaken. The RFS was calculated using the Kaplan–Meier curve. Univariate analysis was done to assess correlation with tumour size, site, the extent of surgery, margin status and adjuvant RT with RFS.

Results:

The median age was 28 years with a male:female ratio of 1:3. The most common location of the tumour was anterior abdominal wall (47%). The median tumour size was 10 cm. Wide local excision was done in most patients. Complete resection with negative margin was achieved in eight patients. Post-operative RT was indicated for 43 patients of whom 19 received RT. At a median follow-up of 37 months, RFS in the complete resection with margin negative group was 100%. RFS for the patients with positive or close margins who received RT was 79% and for those who did not receive RT, it was 87%.

Conclusions:

Complete excision with negative margins gives the best local control in DF. The benefit of post-operative RT could not be ascertained.

Keywords

Desmoid fibromatosismargin statusradiotherapyrelapse-free survival
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 19 , Issue 3 , September 2020 , pp. 259 - 264
Copyright
© Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Cheon, S S, Cheah, A Y L, Turley, Set al. Beta-catenin stabilization dysregulates mesenchymal cell proliferation, motility, and invasiveness and causes aggressive fibromatosis and hyperplastic cutaneous wounds. Proc Natl Acad Sci U S A 2002 May 14; 99 (10): 6973–6978.10.1073/pnas.102657399CrossRefGoogle ScholarPubMed
Reitamo, J J, Häyry, P, Nykyri, E, Saxén, E. The desmoid tumor. I. Incidence, sex-, age- and anatomical distribution in the Finnish population. Am J Clin Pathol 1982 Jun; 77 (6): 665–673.10.1093/ajcp/77.6.665CrossRefGoogle ScholarPubMed
Heiskanen, I, Järvinen, H J. Occurrence of desmoid tumours in familial adenomatous polyposis and results of treatment. Int J Colorectal Dis 1996; 11 (4): 157–162.10.1007/s003840050034CrossRefGoogle ScholarPubMed
Clark, S K, Neale, K F, Landgrebe, J C, Phillips, R K. Desmoid tumours complicating familial adenomatous polyposis. Br J Surg 1999 Sep; 86 (9): 1185–1189.10.1046/j.1365-2168.1999.01222.xCrossRefGoogle ScholarPubMed
Fiore, M, Rimareix, F, Mariani, Let al. Desmoid-type fibromatosis: a front-line conservative approach to select patients for surgical treatment. Ann Surg Oncol 2009 Sep; 16 (9): 2587–2593.10.1245/s10434-009-0586-2CrossRefGoogle ScholarPubMed
Bonvalot, S, Desai, A, Coppola, Set al. The treatment of desmoid tumors: a stepwise clinical approach. Ann Oncol Off J Eur Soc Med Oncol 2012 Sep; 23 (suppl 10): x158–166.10.1093/annonc/mds298CrossRefGoogle Scholar
Choi, S H, Yoon, H I, Kim, S H, Kim, S K, Shin, K-H, Suh, C-O. Optimal radiotherapy strategy for primary or recurrent fibromatosis and long-term results. PLoS One 2018 May 29; 13 (5): e0198134.10.1371/journal.pone.0198134CrossRefGoogle ScholarPubMed
Zlotecki, R A, Scarborough, M T, Morris, C Get al. External beam radiotherapy for primary and adjuvant management of aggressive fibromatosis. Int J Radiat Oncol Biol Phys 2002 Sep 1; 54 (1): 177–181.10.1016/S0360-3016(02)02926-7CrossRefGoogle ScholarPubMed
Francis, W P, Zippel, D, Mack, L Aet al. Desmoids: a revelation in biology and treatment. Ann Surg Oncol 2009 Jun; 16 (6): 1650–1654.10.1245/s10434-008-0285-4CrossRefGoogle ScholarPubMed
Bertagnolli, M M, Morgan, J A, Fletcher, C D Met al. Multimodality treatment of mesenteric desmoid tumours. Eur J Cancer 2008 Nov; 44 (16): 2404–2410.10.1016/j.ejca.2008.06.038CrossRefGoogle ScholarPubMed
de Bree, E, Keus, R, Melissas, J, Tsiftsis, D, van Coevorden, F. Desmoid tumors: need for an individualized approach. Expert Rev Anticancer Ther 2009 Apr; 9 (4): 525–535.CrossRefGoogle ScholarPubMed
Johner, A, Tiwari, P, Zetler, P, Wiseman, S M. Abdominal wall desmoid tumors associated with pregnancy: current concepts. Expert Rev Anticancer Ther 2009 Nov; 9 (11): 1675–1682.10.1586/era.09.98CrossRefGoogle ScholarPubMed
Ballo, M T, Zagars, G K, Pollack, A, Pisters, P W, Pollack, R A. Desmoid tumor: prognostic factors and outcome after surgery, radiation therapy, or combined surgery and radiation therapy. J Clin Oncol Off J Am Soc Clin Oncol 1999 Jan; 17 (1): 158–167.10.1200/JCO.1999.17.1.158CrossRefGoogle ScholarPubMed
Janssen, M L, van Broekhoven, D L M, Cates, J M Met 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 Mar; 104 (4): 347–357.10.1002/bjs.10477CrossRefGoogle ScholarPubMed
Peng, P D, Hyder, O, Mavros, M Net al. Management and recurrence patterns of desmoids tumors: a multi-institutional analysis of 211 patients. Ann Surg Oncol 2012 Dec; 19 (13): 4036–4042.CrossRefGoogle ScholarPubMed
Lev, D, Kotilingam, D, Wei, Cet al. Optimizing treatment of desmoid tumors. J Clin Oncol Off J Am Soc Clin Oncol 2007 May 1; 25 (13): 1785–1791.CrossRefGoogle ScholarPubMed
Huang, K, Wang, C M, Chen, J Get al. Prognostic factors influencing event-free survival and treatments in desmoid-type fibromatosis: analysis from a large institution. Am J Surg 2014 Jun; 207 (6): 847–854.CrossRefGoogle ScholarPubMed
Huang, K, Fu, H, Shi, Y-Q, Zhou, Y, Du, C-Y. Prognostic factors for extra-abdominal and abdominal wall desmoids: a 20-year experience at a single institution. J Surg Oncol 2009 Dec 1; 100 (7): 563–569.CrossRefGoogle ScholarPubMed
Mullen, J T, Delaney, T F, Kobayashi, W Ket al. Desmoid tumor: analysis of prognostic factors and outcomes in a surgical series. Ann Surg Oncol 2012 Dec; 19 (13): 4028–4035.10.1245/s10434-012-2638-2CrossRefGoogle Scholar
Ramamurthy, R, Arumugam, B, Ramanandham, B. Recurrence patterns and management options in aggressive fibromatosis. Indian J Surg Oncol 2012 Sep; 3 (3): 222–227.CrossRefGoogle ScholarPubMed
Casali, P G, Blay, J-Y. ESMO/CONTICANET/EUROBONET Consensus Panel of experts. Soft tissue sarcomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol Off J Eur Soc Med Oncol 2010 May; 21 (suppl 5): v198–203.10.1093/annonc/mdq209CrossRefGoogle Scholar