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Open Access 01-12-2012 | Research

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

Authors: 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

Published in: World Journal of Surgical Oncology | Issue 1/2012

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.

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Title: Recurrence and prognostic factors in patients with aggressive fibromatosis. The role of radical surgery and its limitations
Authors: 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
Publication date: 01-12-2012
Publisher: BioMed Central
Published in: World Journal of Surgical Oncology / Issue 1/2012
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/1477-7819-10-184

At a glance: The STEP trials

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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