Prognostic factors for second recurrence after surgical resection of recurrent desmoid-type fibromatosis

The optimal management of recurrent desmoid-type fibromatosis is undefined. This study was performed to determine what factors, if any, predict second recurrence after surgical resection of recurrent desmoid tumors. Of 41 patients with recurrent desmoid-type fibromatosis, 29 underwent surgical resection and 8 were followed by observation. Four others received adjuvant chemo/pharmacotherapy. Clinicopathologic features were assessed as prognostic factors for second recurrence after surgical resection of recurrent desmoid tumors by Cox proportional hazards regression. Nine of 29 patients who underwent surgical resection of recurrent desmoid tumor developed a second recurrence. Larger size of recurrent tumor was associated with increased risk of second recurrence (hazard ratio, 1.09; P = 0.006). Treatment of the primary tumor with adjuvant radiation therapy also increased risk of re-recurrence (3.41; P = 0.032). Second recurrence of desmoid-type fibromatosis after surgical resection is, much like recurrence of primary desmoid tumor, difficult to predict with current prognostic indicators.