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The Desmoid Tumor Research Foundation

October 2018

Surgical excision versus observation as initial management of desmoid tumors: A population based study

Author Information

Turner B(1), Alghamdi M(2), Henning JW(3), Kurien E(4), Morris D(3), Bouchard-Fortier A(5), Schiller D(6), Puloski S(7), Monument M(7), Itani D(8), Mack LA(5).

(1)Head and Neck Oncologic Surgery & Microvascular Fellowship, 2nd Floor, Faculty Clinics Building University of Florida, Jacksonville 653-1 West 8th Street, Jacksonville, FL, 32209 (2)Division of Medical Oncology, University of Calgary, Calgary, AB, Canada; Dept of Medical Oncology, King Saud University, Riyadh, Saudi Arabia. (3)Division of Medical Oncology, University of Calgary, Calgary, AB, Canada. (4)Division of Radiation Oncology, University of Calgary, Calgary, AB, Canada. (5)Dept of Surgery, University of Calgary, Calgary, AB, Canada.(6)Dept of Surgery, Royal Alexandra Hospital, Edmonton, AB, Canada. (7)Division of Orthopedic Surgery, University of Calgary, Calgary, AB, Canada. (8)Dept of Pathology, University of Calgary, Calgary, AB, Canada.

Publication

Eur J Surg Oncol

Summary

Desmoid tumors can be safely managed with watchful waiting, including either observation alone or tamoxifen/NSAIDs. Surgery at first presentation can be associated with significant treatment burden. All diagnoses of desmoid tumor within the Alberta Cancer Registry from August 2004 to September 2015 were identified. Patients with FAP were excluded. Demographics, tumor characteristics and treatment and outcome data were collected. Outcomes were compared between immediate surgery and watchful waiting. The effect of abdominal wall site on progression and recurrence and the effect of microscopic margin on recurrence were assessed with Fisher's exact test. Watchful waiting was successful in 58% of patients, and a further 28% only required one aggressive treatment thereafter, for a total of 86%. Surgery had a favorable recurrence rate (15%), but some recurrences were associated with significant treatment burden. Treatment should be tailored to individual patients in a multidisciplinary setting. A trial of observation appears warranted in most patients. Recurrence rate was not affected by positive margins.

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