Evolution of Initial Treatment for Desmoid Tumors

Area of Science:

• Oncology
• Surgical Oncology
• Clinical Research

Background:

• Desmoid tumors (DTs) are rare, locally aggressive fibroblastic neoplasms.
• Historically, upfront surgical resection was the primary treatment for DTs.
• Current guidelines advocate for active surveillance as a preferred initial management strategy.

Purpose of the Study:

• To analyze the trend in initial management strategies for desmoid tumors over time.
• To evaluate outcomes for patients managed with active surveillance versus surgical resection.
• To provide data supporting the shift towards active surveillance for DTs.

Main Methods:

• Retrospective chart review of 103 patients with primary desmoid tumors (2007-2020).
• Analysis of initial management strategies: resection, systemic therapy, active surveillance, cryoablation.
• Evaluation of treatment-free survival (TFS), time to treatment (TTT), recurrence-free survival (RFS), and time to recurrence.

Main Results:

• Surgical resection rates significantly decreased from 69.6% before 2018 to 29.2% after 2018 (p < 0.001).
• For upfront resection, 5-year recurrence-free survival was 41.2%.
• For active surveillance, 2-year treatment-free survival was 66.7%, with a median time to treatment of 4 months.

Conclusions:

• A notable transition towards active surveillance for initial desmoid tumor management was observed.
• This trend aligns with contemporary expert panel recommendations and consensus guidelines.
• The study highlights key metrics for desmoid tumor management in the era of active surveillance.