| Peer-Reviewed

Desmoid Tumour Treatment Outcome: A Single Institution Experience

Received: 3 November 2022     Accepted: 21 November 2022     Published: 27 December 2022
Views:       Downloads:
Abstract

Desmoid tumors are benign tumor of connective tissue but with high chances of local recurrence. Surgery is the main treatment modality of therapy if it can be done with acceptable morbidity. Our purpose to present our experience in management of desmoid tumors and our aim is to evaluate the best option in dealing with desmoid tumors and factors affecting the Recurrence Free Survival. This is retrospective trial so medical records of patients diagnosed as desmoid tumors between January 2009 and December 2018 were reviewed at Radiation Oncology section, King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh, Saudi Arabia. Our cohort was 72 consecutive patients. The median age was 27 years, two-thirds were females, median size was 7 cm and most common site was trunk. Twenty four patients were treated with definitive radiotherapy, 15 patients by surgical resection alone and 30 patients by combination of both surgery and radiotherapy. The median follow up was 5.5 years with local control in patients who had radiotherapy as part of treatment was 89% and 87% in patients who had surgery as a part of treatment. The patients who had surgery alone had no recurrence. All the recurrences happened in the lower radiotherapy dose of 50Gy and those who had postoperative radiotherapy. There was no recurrence in the higher radiotherapy dose of 60Gy and those who had preoperative radiotherapy. Most of the recurrence was in patients with tumor size less than 5 cm, in the extremities and in the less than 30 years old group. The 3 years, 5 years and 7years Recurrence Free Survival in patients who had both surgery and radiotherapy was 96.4%, 81.4% and 77.4% respectively. Radiotherapy plays an important role in local control of desmoid tumors. The factors associated with poor response in the cohort of patients are younger age group, lower dose of radiation and post-operative radiotherapy compared to preoperative radiotherapy. The majority of the recurrent tumors were small indicating that biology of the disease is more important.

Published in Journal of Cancer Treatment and Research (Volume 10, Issue 4)
DOI 10.11648/j.jctr.20221004.11
Page(s) 38-42
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Desmoid, Tumor, Treatment, Outcome

References
[1] Penel N, Coindre JM, Bonvalot S, Italiano A, Neuville A, Cesne AL et al. Management of desmoid tumours: a nationwide survey of labelled reference centre networks in France. Eur J Cancer 2016; 58: 90e6.
[2] Kasper B, Stroebel P, Hohenberger P. Desmoid tumors – clinical features and treatment options for advanced disease. The Oncologist 2011; 16: 682-93.
[3] M. T. Ballo, G. K. Zagars, A. Pollack, P. W. Pisters, R. A. Pollack, 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. 17 (1999) 158e167.
[4] B. W. Goy, S. P. Lee, F. Eilber, F. Dorey, J. Eckardt, Y. S. Fu, G. J. Juillard, M. T. Selch, The role of adjuvant radiotherapy in the treatment of resectable desmoid tumors, Int. J. Radiat. Oncol. Biol. Phys. 39 (1997) 659e665.
[5] N. B. Merchant, J. J. Lewis, J. M. Woodruff, D. H. Leung, M. F. Brennan, Extremity and trunk desmoid tumors: a multifactorial analysis of outcome, Cancer 86 (1999) 2045e2052.
[6] A. Gronchi, P. G. Casali, L. Mariani, S. Lo Vullo, M. Colecchia, L. Lozza, R. Bertulli, M. Fiore, P. Olmi, M. Santinami, J. Rosai, Quality of surgery and outcome in extra-abdominal aggressive fibromatosis: a series of patients surgically treated at a single institution, J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol. 21 (2003) 1390e1397.
[7] K. Huang, H. Fu, Y.-Q. Shi, Y. Zhou, C.-Y. Du, Prognostic factors for extraabdominal and abdominal wall desmoids: a 20-year experience at a single institution, J. Surg. Oncol. 100 (2009) 563e569, http://dx.doi.org/10.1002/jso.21384.
[8] D. L. M. van Broekhoven, C. Verhoef, S. G. Elias, A. J. Witkamp, J. M. H. H. van Gorp, B. a. N. van Geel, H. K. Wijrdeman, T. van Dalen, Local recurrence after surgery for primary extra-abdominal desmoid-type fibromatosis, Br. J. Surg. 100 (2013) 1214e1219, http://dx.doi.org/10.1002/bjs.9194.
[9] K. Huang, C. M. Wang, J. G. Chen, C. Y. Du, Y. Zhou, Y. Q. Shi, H. Fu, Prognostic factors influencing event-free survival and treatments in desmoid-type fibromatosis: analysis from a large institution, Am. J. Surg. 207 (2014) 847e854, http://dx.doi.org/10.1016/j.amjsurg.2013.08.007.
[10] W.-G. Zeng, Z.-X. Zhou, J.-W. Liang, H.-R. Hou, Z. Wang, H.-T. Zhou, X.-M. Zhang, J.-J. Hu, Prognostic factors for desmoid tumor: a surgical series of 233 patients at a single institution, Tumour Biol. J. Int. Soc. Oncodevel. Biol. Med. 35 (2014) 7513e7521, http://dx.doi.org/10.1007/s13277-014-2002-1.
[11] M. G. Rock, D. J. Pritchard, H. M. Reiman, E. H. Soule, R. C. Brewster, Extraabdominal desmoid tumors, J. Bone Jt. Surg. Am. 66 (1984) 1369e1374.
[12] Y. Shido, Y. Nishida, H. Nakashima, H. Katagiri, H. Sugiura, Y. Yamada, N. Ishiguro, Surgical treatment for local control of extremity and trunk desmoid tumors, Arch. Orthop. Trauma Surg. 129 (2009) 929e933, http://dx.doi.org/10.1007/s00402-008-0750-3.
[13] A. Sørensen, J. Keller, O. S. Nielsen, O. M. Jensen, Treatment of aggressive fibromatosis: a retrospective study of 72 patients followed for 1-27 years, Acta Orthop. Scand. 73 (2002) 213e219, http://dx.doi.org/10.1080/000164702753671830.
[14] A. Hansmann, C. Adolph, T. Vogel, A. Unger, G. Moeslein, High-dose tamoxifen and sulindac as first-line treatment for desmoid tumors, Cancer 100 (2004) 612e620, http://dx.doi.org/10.1002/cncr.11937.
[15] J. Janinis, M. Patriki, L. Vini, G. Aravantinos, J. S. Whelan, The pharmacological treatment of aggressive fibromatosis: a systematic review, Ann. Oncol. Off. J. Eur. Soc. Med. Oncol. ESMO 14 (2003) 181e190.
[16] N. Penel, A. Le Cesne, B. N. Bui, D. Perol, E. G. Brain, I. Ray-Coquard, C. Guillemet, C. Chevreau, D. Cupissol, S. Chabaud, M. Jimenez, F. Duffaud, S. Piperno-Neumann, L. Mignot, J.-Y. Blay, 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. Off. J. Eur. Soc. Med. Oncol. ESMO 22 (2011) 452e457, http://dx.doi.org/10.1093/annonc/mdq341.
[17] B. Kasper, P. Str€obel, P. Hohenberger, Desmoid tumors: clinical features and treatment options for advanced disease, Oncology 16 (2011) 682e693, http://dx.doi.org/10.1634/theoncologist.2010-0281.
[18] S. Bonvalot, H. Eldweny, V. Haddad, F. Rimareix, G. Missenard, O. Oberlin, D. Vanel, P. Terrier, J. Y. Blay, A. Le Cesne, C. Le P_echoux, Extra-abdominal primary fibromatosis: aggressive management could be avoided in a subgroup of patients, Eur. J. Surg. Oncol. J. Eur. Soc. Surg. Oncol. Br. Assoc. Surg. Oncol. 34 (2008) 462e468, http://dx.doi.org/10.1016/j.ejso.2007.06.006.
[19] N. Eastley, R. Aujla, R. Silk, C. J. Richards, T. A. McCulloch, C. P. Esler, R.U. Ashford, Extra-abdominal desmoid fibromatosisea sarcoma unit review of practice, long term recurrence rates and survival, Eur. J. Surg. Oncol. J. Eur. Soc. Surg. Oncol. Br. Assoc. Surg. Oncol. 40 (2014) 1125e1130, http://dx.doi.org/10.1016/j.ejso.2014.02.226.
[20] E. Stoeckle, J. M. Coindre, M. Longy, M. B. N. Binh, G. Kantor, M. Kind, C. T. de Lara, A. Avril, F. Bonichon, B. N. Bui, A critical analysis of treatment strategies in desmoid tumours: a review of a series of 106 cases, Eur. J. Surg. Oncol. J. Eur. Soc. Surg. Oncol. Br. Assoc. Surg. Oncol. 35 (2009) 129e134, http://dx.doi.org/10.1016/j.ejso.2008.06.1495.
[21] O. Micke, M. H. Seegenschmiedt, German cooperative group on radiotherapy for benign diseases, radiation therapy for aggressive fibromatosis (desmoid tumors): results of a national patterns of care study, Int. J. Radiat. Oncol. Biol. Phys. 61 (2005) 882e891, http://dx.doi.org/10.1016/j.ijrobp.2004.07.705.
[22] J. J. Nuyttens, P. F. Rust, C. R. Thomas, A. T. Turrisi, Surgery versus radiation therapy for patients with aggressive fibromatosis or desmoid tumors: a comparative review of 22 articles, Cancer 88 (2000) 1517e1523.
Cite This Article
  • APA Style

    Mohamed Wahba Hegazy, Mohamed Rizwanullah. (2022). Desmoid Tumour Treatment Outcome: A Single Institution Experience. Journal of Cancer Treatment and Research, 10(4), 38-42. https://doi.org/10.11648/j.jctr.20221004.11

    Copy | Download

    ACS Style

    Mohamed Wahba Hegazy; Mohamed Rizwanullah. Desmoid Tumour Treatment Outcome: A Single Institution Experience. J. Cancer Treat. Res. 2022, 10(4), 38-42. doi: 10.11648/j.jctr.20221004.11

    Copy | Download

    AMA Style

    Mohamed Wahba Hegazy, Mohamed Rizwanullah. Desmoid Tumour Treatment Outcome: A Single Institution Experience. J Cancer Treat Res. 2022;10(4):38-42. doi: 10.11648/j.jctr.20221004.11

    Copy | Download

  • @article{10.11648/j.jctr.20221004.11,
      author = {Mohamed Wahba Hegazy and Mohamed Rizwanullah},
      title = {Desmoid Tumour Treatment Outcome: A Single Institution Experience},
      journal = {Journal of Cancer Treatment and Research},
      volume = {10},
      number = {4},
      pages = {38-42},
      doi = {10.11648/j.jctr.20221004.11},
      url = {https://doi.org/10.11648/j.jctr.20221004.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jctr.20221004.11},
      abstract = {Desmoid tumors are benign tumor of connective tissue but with high chances of local recurrence. Surgery is the main treatment modality of therapy if it can be done with acceptable morbidity. Our purpose to present our experience in management of desmoid tumors and our aim is to evaluate the best option in dealing with desmoid tumors and factors affecting the Recurrence Free Survival. This is retrospective trial so medical records of patients diagnosed as desmoid tumors between January 2009 and December 2018 were reviewed at Radiation Oncology section, King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh, Saudi Arabia. Our cohort was 72 consecutive patients. The median age was 27 years, two-thirds were females, median size was 7 cm and most common site was trunk. Twenty four patients were treated with definitive radiotherapy, 15 patients by surgical resection alone and 30 patients by combination of both surgery and radiotherapy. The median follow up was 5.5 years with local control in patients who had radiotherapy as part of treatment was 89% and 87% in patients who had surgery as a part of treatment. The patients who had surgery alone had no recurrence. All the recurrences happened in the lower radiotherapy dose of 50Gy and those who had postoperative radiotherapy. There was no recurrence in the higher radiotherapy dose of 60Gy and those who had preoperative radiotherapy. Most of the recurrence was in patients with tumor size less than 5 cm, in the extremities and in the less than 30 years old group. The 3 years, 5 years and 7years Recurrence Free Survival in patients who had both surgery and radiotherapy was 96.4%, 81.4% and 77.4% respectively. Radiotherapy plays an important role in local control of desmoid tumors. The factors associated with poor response in the cohort of patients are younger age group, lower dose of radiation and post-operative radiotherapy compared to preoperative radiotherapy. The majority of the recurrent tumors were small indicating that biology of the disease is more important.},
     year = {2022}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Desmoid Tumour Treatment Outcome: A Single Institution Experience
    AU  - Mohamed Wahba Hegazy
    AU  - Mohamed Rizwanullah
    Y1  - 2022/12/27
    PY  - 2022
    N1  - https://doi.org/10.11648/j.jctr.20221004.11
    DO  - 10.11648/j.jctr.20221004.11
    T2  - Journal of Cancer Treatment and Research
    JF  - Journal of Cancer Treatment and Research
    JO  - Journal of Cancer Treatment and Research
    SP  - 38
    EP  - 42
    PB  - Science Publishing Group
    SN  - 2376-7790
    UR  - https://doi.org/10.11648/j.jctr.20221004.11
    AB  - Desmoid tumors are benign tumor of connective tissue but with high chances of local recurrence. Surgery is the main treatment modality of therapy if it can be done with acceptable morbidity. Our purpose to present our experience in management of desmoid tumors and our aim is to evaluate the best option in dealing with desmoid tumors and factors affecting the Recurrence Free Survival. This is retrospective trial so medical records of patients diagnosed as desmoid tumors between January 2009 and December 2018 were reviewed at Radiation Oncology section, King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh, Saudi Arabia. Our cohort was 72 consecutive patients. The median age was 27 years, two-thirds were females, median size was 7 cm and most common site was trunk. Twenty four patients were treated with definitive radiotherapy, 15 patients by surgical resection alone and 30 patients by combination of both surgery and radiotherapy. The median follow up was 5.5 years with local control in patients who had radiotherapy as part of treatment was 89% and 87% in patients who had surgery as a part of treatment. The patients who had surgery alone had no recurrence. All the recurrences happened in the lower radiotherapy dose of 50Gy and those who had postoperative radiotherapy. There was no recurrence in the higher radiotherapy dose of 60Gy and those who had preoperative radiotherapy. Most of the recurrence was in patients with tumor size less than 5 cm, in the extremities and in the less than 30 years old group. The 3 years, 5 years and 7years Recurrence Free Survival in patients who had both surgery and radiotherapy was 96.4%, 81.4% and 77.4% respectively. Radiotherapy plays an important role in local control of desmoid tumors. The factors associated with poor response in the cohort of patients are younger age group, lower dose of radiation and post-operative radiotherapy compared to preoperative radiotherapy. The majority of the recurrent tumors were small indicating that biology of the disease is more important.
    VL  - 10
    IS  - 4
    ER  - 

    Copy | Download

Author Information
  • Section of Radiation Oncology, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia

  • Section of Radiation Oncology, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia

  • Sections