Effect of surgical margins on prognosis in aggressive fibromatosis: A single_institutional analysis of 90 patients

Summary

The present retrospective analysis aimed to determine prognostic factors leading to recurrence. Between 2000 and 2014, 114 patients with aggressive fibromatosis were treated surgically at BG_University Hospital Bergmannsheil (Bochum, Germany). Primary tumors were resected with negative margins (R0) in 50 patients (68%) and with microscopically positive margins (R1) in 28 patients (25%). In addition, tumors in 12 patients (7%) were resected with macroscopically positive margins at the initial surgical procedure. The rates of recurrence_free survival (RFS) after 5 years were 68.8% [95% confidence interval (CI), 53.5_79.9%] in patients with R0_resected primary tumors and 34.1% (95% CI, 19.9_48.9%) in patients with R1/R2_status (P=0.001). Narrow and wide clear margins within the R0_group were not associated with significantly different outcomes. Adjuvant radiation, tumor site and patient age were not associated with a significant alteration of RFS. The current results suggest that the attainment of microscopically negative surgical margins at the initial surgical treatment is associated with a significantly improved prognosis.