The therapeutic effect of a new method on reducing local recurrence rate of desmoid tumors involving adjacent nerves and blood vessels based on blocking-capsule theory

Summary

Capsule and pseudocapsule are correlated with higher complete tumor excision rate and lower incidence of recurrence by restricting tumor growth and block its invasion. Based on the blocking-capsule theory, we applied artificial capsule to desmoid tumors, which are locally infiltrative neoplasms with a high local recurrence rate especially when involving nerves and blood vessels, and tested whether local recurrence rate can be reduced. We performed a retrospective review of seven cases of desmoid tumor adjacent to nerves and blood vessels. We used polyester patch to envelope or separate the involved nerves and blood vessels after the excision of desmoid tumors of the seven patients. Among the seven patients, five of them had recurrent desmoid tumors before the excision and blocking-patch surgery. After the surgery, no local recurrence was observed in six of them. As for the rest one with local recurrence one year after the excision, MR images demonstrated that tumor located only in the region where neurovascular structures were not enveloped by polyester patch. Patch enveloping is a new method to protect neurovascular structures from the invasion of desmoid tumors, and reduces the local recurrence rate after excision, potentially supporting the blocking-capsule theory. Prospective study will be conducted to further examine the theory and method in the future.