Kim Y(1), Rosario MS(1)(2), Cho HS(3), Han I(1)(4).
(1)Musculoskeletal Tumor Center, Seoul National University Cancer Hospital, Seoul, Korea. (2)East Avenue Medical Center, Quezon City, Philippines. (3)Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea. (4)Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
Publication
Clin Orthop Surg
Summary
In this study, we aimed to assess the disease stabilization rate and identify predictive factors for disease stabilization of desmoid-type fibromatosis (DF) in patients with conservative treatment. We reviewed 76 patients with sporadic extra-abdominal DF who were managed with frontline conservative treatment in our institute. The minimum follow-up was 12 months. Stabilization was defined as radiological evidence of no change or continuous decrease in size of the tumor for six months or more. The primary endpoint was stabilization of DF. Possible patient-, disease-, and treatment-related factors predictive of disease stabilization were analyzed with multivariate analysis. At final follow-up, 54 of the 76 tumors (71%) were stable, and mean time to stabilization was 30.4 months (range, 7 to 112 months). On Kaplan-Meier survival analysis, the spontaneous stabilization rate was 25.4% at one year, 52.7% at two years, and 70.9% at three years. The mean time to spontaneous stabilization was longer in patients with ≤ 40 years of age (p = 0.022) or recurrence (p = 0.041). On multivariate analysis with the Cox proportional hazard method, recurrence (hazard ratio [HR], 1.79; p = 0.041) and younger age (HR, 2.04; p = 0.022) were identified as independent prognostic factors for longer time to disease stabilization. Frontline conservative treatment seems to be the optimal treatment for most patients with DF. Younger patients or those with recurrence may require longer time to spontaneous disease stabilization.
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