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Desmoid tumors: a novel approach for local control
Christopher R Baliski1, Walley J Temple, Keith Arthur
1Department of Oncology, Tom Baker Cancer Centre and University of Calgary, Calgary, Canada.
Journal of Surgical Oncology
|August 14, 2002
Summary
Neoadjuvant chemotherapy and radiation before surgery significantly improved local control for desmoid tumors, reducing recurrence rates to 15%. This approach offers a better alternative to surgery alone for potentially resectable lesions.
Area of Science:
- Oncology
- Surgical Oncology
- Medical Oncology
Background:
- Desmoid tumors have a high recurrence rate (25-50%) after surgical resection.
- Local control remains a challenge in managing desmoid tumors.
- Novel treatment strategies are needed to improve outcomes.
Purpose of the Study:
- To evaluate the efficacy of neoadjuvant chemotherapy and radiotherapy in improving local control of desmoid tumors.
- To assess the feasibility and safety of a combined neoadjuvant treatment protocol.
- To compare outcomes with historical data on surgery alone.
Main Methods:
- A prospective cohort study involving 13 patients with potentially resectable desmoid tumors.
- Neoadjuvant treatment consisted of doxorubicin and radiotherapy prior to surgical resection.
- Surgical resection aimed for 1 cm margins, with acceptance of clear adventitial margins to preserve critical structures.
Main Results:
- A 15% local recurrence rate was observed in 13 patients over a median follow-up of 71 months.
- Eleven patients achieved disease-free status.
- Clear microscopic margins were obtained in 11 patients; 2 had positive margins.
Conclusions:
- Neoadjuvant doxorubicin and radiotherapy followed by resection provides excellent local control for desmoid tumors, including recurrent cases.
- This protocol appears superior to surgery alone or surgery with adjuvant radiotherapy.
- Larger, prospective randomized trials are required to confirm these findings.