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Effect of surgical margins on prognosis in aggressive fibromatosis: A single-institutional analysis of 90 patients
The treatment of aggressive fibromatosis poses a therapeutic challenge in an interdisciplinary setting. The extent of surgical resection is still discussed controversially. The present retrospective analysis aimed to determine prognostic factors leading to recurrence. Between 2000 and 2014, 114 pati...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
D.A. Spandidos
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5661366/ https://www.ncbi.nlm.nih.gov/pubmed/29113152 http://dx.doi.org/10.3892/ol.2017.6864 |
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author | Harati, Kamran Jaenisch, Anais Behr, Björn Goertz, Ole Harati, Ali Hirsch, Tobias Stricker, Ingo Lehnhardt, Marcus Daigeler, Adrien |
author_facet | Harati, Kamran Jaenisch, Anais Behr, Björn Goertz, Ole Harati, Ali Hirsch, Tobias Stricker, Ingo Lehnhardt, Marcus Daigeler, Adrien |
author_sort | Harati, Kamran |
collection | PubMed |
description | The treatment of aggressive fibromatosis poses a therapeutic challenge in an interdisciplinary setting. The extent of surgical resection is still discussed controversially. The present retrospective analysis aimed to determine prognostic factors leading to recurrence. Between 2000 and 2014, 114 patients with aggressive fibromatosis were treated surgically at BG-University Hospital Bergmannsheil (Bochum, Germany). Univariate and multivariate analyses were restricted to 90 participants with information available on surgical margins at the initial procedure. The median follow-up time was 7.7 years. A total of 45 patients (50%) developed recurrence during follow-up. Primary tumors were resected with negative margins (R0) in 50 patients (68%) and with microscopically positive margins (R1) in 28 patients (25%). In addition, tumors in 12 patients (7%) were resected with macroscopically positive margins at the initial surgical procedure. The rates of recurrence-free survival (RFS) after 5 years were 68.8% [95% confidence interval (CI), 53.5–79.9%] in patients with R0-resected primary tumors and 34.1% (95% CI, 19.9–48.9%) in patients with R1/R2-status (P=0.001). Narrow and wide clear margins within the R0-group were not associated with significantly different outcomes. Adjuvant radiation, tumor site and patient age were not associated with a significant alteration of RFS. The current results suggest that the attainment of microscopically negative surgical margins at the initial surgical treatment is associated with a significantly improved prognosis. A conservative surgical approach involving the attainment of narrow negative margins while preserving function should be sought in patients in whom tumor resection is indicated. The decision for resection should be made interdisciplinary in each case based on tumor progression, available treatment alternatives and the decision of the informed patient. |
format | Online Article Text |
id | pubmed-5661366 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | D.A. Spandidos |
record_format | MEDLINE/PubMed |
spelling | pubmed-56613662017-11-06 Effect of surgical margins on prognosis in aggressive fibromatosis: A single-institutional analysis of 90 patients Harati, Kamran Jaenisch, Anais Behr, Björn Goertz, Ole Harati, Ali Hirsch, Tobias Stricker, Ingo Lehnhardt, Marcus Daigeler, Adrien Oncol Lett Articles The treatment of aggressive fibromatosis poses a therapeutic challenge in an interdisciplinary setting. The extent of surgical resection is still discussed controversially. The present retrospective analysis aimed to determine prognostic factors leading to recurrence. Between 2000 and 2014, 114 patients with aggressive fibromatosis were treated surgically at BG-University Hospital Bergmannsheil (Bochum, Germany). Univariate and multivariate analyses were restricted to 90 participants with information available on surgical margins at the initial procedure. The median follow-up time was 7.7 years. A total of 45 patients (50%) developed recurrence during follow-up. Primary tumors were resected with negative margins (R0) in 50 patients (68%) and with microscopically positive margins (R1) in 28 patients (25%). In addition, tumors in 12 patients (7%) were resected with macroscopically positive margins at the initial surgical procedure. The rates of recurrence-free survival (RFS) after 5 years were 68.8% [95% confidence interval (CI), 53.5–79.9%] in patients with R0-resected primary tumors and 34.1% (95% CI, 19.9–48.9%) in patients with R1/R2-status (P=0.001). Narrow and wide clear margins within the R0-group were not associated with significantly different outcomes. Adjuvant radiation, tumor site and patient age were not associated with a significant alteration of RFS. The current results suggest that the attainment of microscopically negative surgical margins at the initial surgical treatment is associated with a significantly improved prognosis. A conservative surgical approach involving the attainment of narrow negative margins while preserving function should be sought in patients in whom tumor resection is indicated. The decision for resection should be made interdisciplinary in each case based on tumor progression, available treatment alternatives and the decision of the informed patient. D.A. Spandidos 2017-11 2017-09-01 /pmc/articles/PMC5661366/ /pubmed/29113152 http://dx.doi.org/10.3892/ol.2017.6864 Text en Copyright: © Harati et al. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (https://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. |
spellingShingle | Articles Harati, Kamran Jaenisch, Anais Behr, Björn Goertz, Ole Harati, Ali Hirsch, Tobias Stricker, Ingo Lehnhardt, Marcus Daigeler, Adrien Effect of surgical margins on prognosis in aggressive fibromatosis: A single-institutional analysis of 90 patients |
title | Effect of surgical margins on prognosis in aggressive fibromatosis: A single-institutional analysis of 90 patients |
title_full | Effect of surgical margins on prognosis in aggressive fibromatosis: A single-institutional analysis of 90 patients |
title_fullStr | Effect of surgical margins on prognosis in aggressive fibromatosis: A single-institutional analysis of 90 patients |
title_full_unstemmed | Effect of surgical margins on prognosis in aggressive fibromatosis: A single-institutional analysis of 90 patients |
title_short | Effect of surgical margins on prognosis in aggressive fibromatosis: A single-institutional analysis of 90 patients |
title_sort | effect of surgical margins on prognosis in aggressive fibromatosis: a single-institutional analysis of 90 patients |
topic | Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5661366/ https://www.ncbi.nlm.nih.gov/pubmed/29113152 http://dx.doi.org/10.3892/ol.2017.6864 |
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