Desmoid tumor surgery: Difference between revisions
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==Overview== | ==Overview== | ||
==Surgery== | ==Surgery== | ||
It does not have any propensity for metastasis although can aggressively invade structures. The optimal management for aggressive fibromatosis depends on tumor location and extent. Surgical resection may be offered although the likelihood of local recurrence after surgery is high, particularly if margins are positive. Moderate-dose radiotherapy alone for gross disease or after a microscopically incomplete resection yields local control rates of approximately 75-80%. Treatment with pharmacologic agents results in objective response rates of approximately 40-50%. | It does not have any propensity for metastasis although can aggressively invade structures. The optimal management for aggressive fibromatosis depends on tumor location and extent. Surgical resection may be offered although the likelihood of local recurrence after surgery is high, particularly if margins are positive. Moderate-dose radiotherapy alone for gross disease or after a microscopically incomplete resection yields local control rates of approximately 75-80%. Treatment with pharmacologic agents results in objective response rates of approximately 40-50%. Wide local excision followed by reconstruction of the defect is the treatment of choice. Full-thickness resection of the tumor-containing abdominal wall with a grossly negative margin has to be performed when the lesion closely approximates or involves the peritoneum. Intraperitoneal organs or adjacent bony structures involved by tumor must be resected as well. Incomplete tumor removal or involved excision margins may lead to local recurrence [1-6]. | ||
The recurrence rate of desmoid tumors is 20% to 77% depending on the location, extent and completeness of the initial resection. Abdominal wall desmoid tumors have a significantly lower recurrence rate. Their recurrence is 20% to 30% and usually becomes evident within six months after excision or in connection with subsequent gestations or deliveries. Metastatic disease has not been reported with desmoid tumor | |||
Revision as of 16:48, 21 January 2016
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Desmoid tumor Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Faizan Sheraz, M.D. [2]
Overview
Surgery
It does not have any propensity for metastasis although can aggressively invade structures. The optimal management for aggressive fibromatosis depends on tumor location and extent. Surgical resection may be offered although the likelihood of local recurrence after surgery is high, particularly if margins are positive. Moderate-dose radiotherapy alone for gross disease or after a microscopically incomplete resection yields local control rates of approximately 75-80%. Treatment with pharmacologic agents results in objective response rates of approximately 40-50%. Wide local excision followed by reconstruction of the defect is the treatment of choice. Full-thickness resection of the tumor-containing abdominal wall with a grossly negative margin has to be performed when the lesion closely approximates or involves the peritoneum. Intraperitoneal organs or adjacent bony structures involved by tumor must be resected as well. Incomplete tumor removal or involved excision margins may lead to local recurrence [1-6].
The recurrence rate of desmoid tumors is 20% to 77% depending on the location, extent and completeness of the initial resection. Abdominal wall desmoid tumors have a significantly lower recurrence rate. Their recurrence is 20% to 30% and usually becomes evident within six months after excision or in connection with subsequent gestations or deliveries. Metastatic disease has not been reported with desmoid tumor