The First Evidence-Based Consensus for Desmoid Tumor Management
The Global Consensus Paper, partially funded by a DTRF grant, is a powerful resource for desmoid tumor patients, caregivers, and medical professionals. The paper provides answers to critical questions regarding recommened treatments, types of treatments, and pain management. Work is underway to update this important resource, with a new version expected by the end of 2023 or early 2024.
Entitled “The Management of desmoid tumors: A joint global consensus-based guideline approach for adult and paediatric patients,” the Paper was published in March 2020 in the European Journal of Cancer and in October 2020, in the ACS Journals.
This booklet was derived from the Global Consensus Paper.
Guiding a Standard of Care
The Global Consensus Paper evaluates existing evidence from prior scientific publications and incorporates the input of desmoid tumor experts worldwide, making it the first international evidence-based consensus of its kind for treatment of desmoid tumors.
There are varying treatments used for desmoid tumors and access to medical therapies and information varies by country. Many patients are treated based on the experience and expertise of a single physician, which may be limited. We have made it a priority to improve this situation by making this collaborative paper available to physicians and patients worldwide.
The Consensus Guidelines on Desmoid Tumor Treatment
According to the Paper, active surveillance – a period of observing the tumor without intervention – is the “well-established primary approach to primary/recurrent sporadic/familial desmoid tumours. Surgery is the accepted second-line treatment only for sporadic desmoid tumors located in the abdominal wall failing observation.”
As shown in the treatment algorithm chart from the Paper, if further treatment is needed it is generally guided according to the anatomical site. The decision should be made with the patients in a stepwise approach:
- For abdominal wall desmoid tumors, surgery is still the first option in case of progression.
- For intra-abdominal / retroperitoneal / pelvic desmoid tumors, systemic therapy should be considered as the first treatment option.
- For extremity / girdles / chest wall desmoid tumors, again surgery should not be the first treatment option unless the expected morbidity is very low (and only following MDT discussion); medical therapy should be administered preferably. Besides surgery, radiotherapy and medical therapy, isolated limb perfusion (ILP) may be part of the further treatment strategy in this location.
- For head & neck / intrathoracic desmoid tumors, medical therapy is generally considered the first line option.
Sx*: Surgery is an option if mobility is limited
MTx: Medical treatment
ILP: Isolated limb perfusion.
“[The Global Consensus Paper is] a gem!!! It literally travels with me to every medical appointment and is read and re-read prior to all appointments with doctors. This document is highlighted in multiple colors, pages dog eared, and paragraphs and charts flagged. This consensus guideline paper has worked for us to guide and empower us and often to redirect/revisit comments or to ask clarifying follow up questions.”
– Caregiver living in Arizona
Bernd Kasper, MD, PhD
“An Overview of Medical Desmoid Tumor Treatments”
Thanks to our collaborators and donors, we’ve helped hundreds of patients and physicians advocate for better care.
The Global Consensus Paper would not have been possible without the hard work and collaboration of an international group of physicians, scientists, and patient advocates.
This paper is the result of a 2018 DTRF grant entitled “An evidence-based consensus on the treatment of desmoids/aggressive fibromatosis.” This essential research relies on donor support. Please consider supporting initiatives like this with a donation to the DTRF.