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Spontaneous Regression of Primary Abdominal Wall Desmoid Tumors: More Common than Previously Thought

  • Bone and Soft Tissue Sarcomas
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

The relevance of the initial observational approach for desmoid tumors (DTs) remains unclear. We investigated a new conservative management treatment for primary abdominal wall DTs.

Methods

Data were collected from 147 patients between 1993 and 2012. The initial therapeutic approaches were categorized as front-line surgery [surgery group (SG), n = 41, 28 %] and initial observation or medical treatment [nonsurgery group (NSG), n = 106, 72 %]. The cumulative incidence of the last strategy modification was estimated using competing risk methods with variable censoring times.

Results

Of the 147 patients, 143 were female (97 %). In the SG, 27 patients (66 %) required full-thickness abdominal wall mesh repair. In the NSG, 102 patients (96 %) underwent initial observation and four received medical treatment. In the NSG, the 1- and 3-year incidences of changing to medical treatment (no further changes during the follow-up) were 19 % [95 % confidence interval (CI) 11–28] and 25 % (95 % CI 17–35), respectively, and the 1- and 3-year incidences of a final switch to surgery were 14 % (95 % CI 8–22) and 16 % (95 % CI 9–24), respectively. An initial tumor size of >7 cm was associated with a higher strategy modification risk (p = 0.004). Of the 102 patients initially observed, 29 experienced spontaneous regression over a median follow-up period of 32 months. All second-intent resections were macroscopically completed, with R0 resections achieved in 82 % of patients.

Conclusions

This study supports an initial nonsurgical approach to abdominal wall DTs ≤7 cm, followed by surgery based on tumor growth in select cases.

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DISCLOSURE

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Surgery, Gustave Roussy Institute, Villejuif, France

    Sylvie Bonvalot MD, PhD, Georgina Bitsakou MD & Charles Honoré MD

  2. Biostatistics and Epidemiology Unit, Gustave Roussy Institute, Villejuif, France

    Nils Ternès MS & Ariane Dunant MS

  3. Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Marco Fiore MD, Chiara Colombo MD & Alessandro Gronchi MD

  4. Department of Cancer Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Andrea Marrari MD

  5. Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France

    Axel Le Cesne MD

  6. Department of Pathology and Molecular Biology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Federica Perrone MD

Authors
  1. Sylvie Bonvalot MD, PhD
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  2. Nils Ternès MS
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  3. Marco Fiore MD
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  4. Georgina Bitsakou MD
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  5. Chiara Colombo MD
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  6. Charles Honoré MD
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  8. Axel Le Cesne MD
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  9. Federica Perrone MD
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  11. Alessandro Gronchi MD
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Corresponding authors

Correspondence to Sylvie Bonvalot MD, PhD or Alessandro Gronchi MD.

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Bonvalot, S., Ternès, N., Fiore, M. et al. Spontaneous Regression of Primary Abdominal Wall Desmoid Tumors: More Common than Previously Thought. Ann Surg Oncol 20, 4096–4102 (2013). https://doi.org/10.1245/s10434-013-3197-x

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  • DOI: https://doi.org/10.1245/s10434-013-3197-x

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