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Local control of extra-abdominal desmoid tumors: systematic review and meta-analysis

The local control of desmoid tumors constitutes a continuing treatment dilemma due to its high recurrence rates. The purpose of this systematic review was to critically examine the current treatment of these rare tumors and to specifically evaluate the local failure and response rates of surgery, ra...

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Autores principales: Wood, Thomas J., Quinn, Kathleen M., Farrokhyar, Forough, Deheshi, Ben, Corbett, Tom, Ghert, Michelle A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: PAGEPress Publications 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3682454/
https://www.ncbi.nlm.nih.gov/pubmed/23772301
http://dx.doi.org/10.4081/rt.2013.e2
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author Wood, Thomas J.
Quinn, Kathleen M.
Farrokhyar, Forough
Deheshi, Ben
Corbett, Tom
Ghert, Michelle A.
author_facet Wood, Thomas J.
Quinn, Kathleen M.
Farrokhyar, Forough
Deheshi, Ben
Corbett, Tom
Ghert, Michelle A.
author_sort Wood, Thomas J.
collection PubMed
description The local control of desmoid tumors constitutes a continuing treatment dilemma due to its high recurrence rates. The purpose of this systematic review was to critically examine the current treatment of these rare tumors and to specifically evaluate the local failure and response rates of surgery, radiation and systemic therapy. We comprehensively searched the literature for relevant studies across Cinahl, Embase, Medline and the Cochrane databases. Articles were categorized as surgery, radiation, surgery + radiation and systemic therapy (including cytotoxic and non cytotoxic). Methodological quality of included studies was assessed using the Newcastle-Ottawa Scale. Pooled odd ratios (OR) for comparative studies and weighted proportions with 95% confidence intervals (CI) are reported. Thirty-five articles were included in the final analysis. Weighted mean local failure rates were 22% [95% CI (16–28%)], 35% [95% CI (26–44%)] and 28% [95% CI (18–39%)] for radiation alone, surgery alone and surgery + radiation respectively. In the analysis of comparative studies, surgery and radiation in combination had lower local failure rates than radiation alone [OR 0.7 (0.4, 1.2)] and surgery alone [OR 0.7 (0.4, 1.0)]. Weighted mean stable disease rates were 91% [95% CI (85–96%)] and 52% [95% CI (38–65%)] for non cytotoxic and cytotoxic chemotherapy respectively. The current evidence suggests that surgery alone has a consistently high rate of local recurrence in managing extra-abdominal desmoid tumors. Radiation therapy in combination with surgery improves local control rates. However, the limited data on systemic therapy for this rare tumor suggests the benefit of using both cytotoxic and non cytotoxic chemotherapy to achieve stable disease.
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spelling pubmed-36824542013-06-14 Local control of extra-abdominal desmoid tumors: systematic review and meta-analysis Wood, Thomas J. Quinn, Kathleen M. Farrokhyar, Forough Deheshi, Ben Corbett, Tom Ghert, Michelle A. Rare Tumors Article The local control of desmoid tumors constitutes a continuing treatment dilemma due to its high recurrence rates. The purpose of this systematic review was to critically examine the current treatment of these rare tumors and to specifically evaluate the local failure and response rates of surgery, radiation and systemic therapy. We comprehensively searched the literature for relevant studies across Cinahl, Embase, Medline and the Cochrane databases. Articles were categorized as surgery, radiation, surgery + radiation and systemic therapy (including cytotoxic and non cytotoxic). Methodological quality of included studies was assessed using the Newcastle-Ottawa Scale. Pooled odd ratios (OR) for comparative studies and weighted proportions with 95% confidence intervals (CI) are reported. Thirty-five articles were included in the final analysis. Weighted mean local failure rates were 22% [95% CI (16–28%)], 35% [95% CI (26–44%)] and 28% [95% CI (18–39%)] for radiation alone, surgery alone and surgery + radiation respectively. In the analysis of comparative studies, surgery and radiation in combination had lower local failure rates than radiation alone [OR 0.7 (0.4, 1.2)] and surgery alone [OR 0.7 (0.4, 1.0)]. Weighted mean stable disease rates were 91% [95% CI (85–96%)] and 52% [95% CI (38–65%)] for non cytotoxic and cytotoxic chemotherapy respectively. The current evidence suggests that surgery alone has a consistently high rate of local recurrence in managing extra-abdominal desmoid tumors. Radiation therapy in combination with surgery improves local control rates. However, the limited data on systemic therapy for this rare tumor suggests the benefit of using both cytotoxic and non cytotoxic chemotherapy to achieve stable disease. PAGEPress Publications 2013-02-11 /pmc/articles/PMC3682454/ /pubmed/23772301 http://dx.doi.org/10.4081/rt.2013.e2 Text en ©Copyright T.J. Wood et al., 2013 This work is licensed under a Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0). Licensee PAGEPress, Italy
spellingShingle Article
Wood, Thomas J.
Quinn, Kathleen M.
Farrokhyar, Forough
Deheshi, Ben
Corbett, Tom
Ghert, Michelle A.
Local control of extra-abdominal desmoid tumors: systematic review and meta-analysis
title Local control of extra-abdominal desmoid tumors: systematic review and meta-analysis
title_full Local control of extra-abdominal desmoid tumors: systematic review and meta-analysis
title_fullStr Local control of extra-abdominal desmoid tumors: systematic review and meta-analysis
title_full_unstemmed Local control of extra-abdominal desmoid tumors: systematic review and meta-analysis
title_short Local control of extra-abdominal desmoid tumors: systematic review and meta-analysis
title_sort local control of extra-abdominal desmoid tumors: systematic review and meta-analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3682454/
https://www.ncbi.nlm.nih.gov/pubmed/23772301
http://dx.doi.org/10.4081/rt.2013.e2
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