The Desmoid Tumor Research Foundation

August 2020

Event-free survival in Desmoid-Type fibromatosis (DTF): A pre-post comparison of upfront surgery versus wait-and-see approach

Author Information

Ruspi L(1), Cananzi FCM(1), Sicoli F(2), Sama L(1), Renne SL(3), Marrari A(4), Gennaro N(5), Colombo P(6), Cozzaglio L(2), Politi LS(5), Bertuzzi A(4), Quagliuolo V(2).

(1)Sarcoma, Melanoma & Rare Tumors Surg Unit, Humanitas Clinical & Research Center - IRCCS, Rozzano, Milan, IT; Dept of Biomedical Sciences, Humanitas Univ, Pieve Emanuele, Milan, IT. (2)Sarcoma, Melanoma & Rare Tumors Surg Unit, Humanitas Clinical & Research Center - IRCCS, Rozzano, Milan, IT. (3)Dept of Biomedical Sciences, Humanitas Univ, Pieve Emanuele, Milan, IT; Pathology Unit, Humanitas Clinical & Research Center - IRCCS, Rozzano, Milan, IT. (4)Oncology Unit, Humanitas Clinical & Research Center - IRCCS, Rozzano, Milan, IT. (5)Dept of Biomedical Sciences, Humanitas Univ, Pieve Emanuele, Milan, Italy; Neuroradiology Unit, Humanitas Clinical & Research Center - IRCCS, Rozzano, Milan, IT. (6)Pathology Unit, Humanitas Clinical & Research Center - IRCCS, Rozzano, Milan, IT.

Publication

Eur J Surg Oncol

Summary

We analyzed 87 consecutive patients with histologically-proven sporadic primary DTF, first recurrence or residual disease managed at our institution between 2000 and 2018. Patients and tumor-related variables were reviewed and analyzed. Two different treatment strategies were adopted according to different time periods: in the "early period" (2000-2010) patients underwent surgical treatment irrespective of the clinical presentation, whereas in the "late period" (2012-2018) asymptomatic patients used to undergo a wait-and-see strategy. The event-free survival (EFS) was compared trough a pre-post comparison. In the early period, surgery was performed in 51 (94.4%) patients and watchful waiting in 3 (5.6%). In the late period, the watchful waiting group accounted for 24 (72.7%) patients and the surgical group for 9 (27.3%). No statistically independent prognostic factors were found. EFS did not show statistically significant differences between early and late period groups. Wait-and-see policy has shown to be equivalent to upfront surgery in terms of EFS; therefore, a conservative approach is recommended in asymptomatic patients diagnosed with DTF that can be followed through watchful waiting.

View Abstract