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Margins in extra-abdominal desmoid tumors: a comparative analysis
Andreas Leithner1, Markus Gapp, Katharina Leithner
1Department of Orthopedic Surgery, Medical University Graz, Graz, Austria.
Journal of Surgical Oncology
|June 2, 2004
Summary
Achieving wide or radical surgical margins significantly reduces recurrence rates for extra-abdominal desmoid tumors. Microscopic margin status is a crucial prognostic factor, guiding treatment decisions for these rare tumors.
Area of Science:
- Surgical Oncology
- Pathology
- Oncology
Background:
- Extra-abdominal desmoid tumors often recur after surgery, with rates up to 80%.
- The prognostic significance of microscopic surgical margin status, using the Enneking classification, is debated for these tumors.
Purpose of the Study:
- To evaluate the impact of microscopic surgical margin status on recurrence rates in extra-abdominal desmoid tumors.
- To determine if wide or radical excision is superior to marginal or intralesional excision.
Main Methods:
- A systematic literature review was conducted to identify relevant studies.
- Included studies had >10 patients, focused solely on surgical treatment, and reported margin status.
Main Results:
- Only 12 of 49 studies met inclusion criteria.
- Wide/radical excision (152 tumors) had a 27% recurrence rate vs. marginal/intralesional excision (260 tumors) with a 72% recurrence rate.
- Microscopic surgical margin status is a significant prognostic factor (P < 0.001).
Conclusions:
- Wide or radical local excision is the recommended treatment strategy for extra-abdominal desmoid tumors.
- Future studies should consistently report exact microscopic surgical margin status to improve comparability.