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Ihalainen HR, Koljonen V, Böhling TO, Tukiainen EJ, Sampo MM. The desmoid tumour: local control after surgical treatment. J Plast Surg Hand Surg 2014; 49:19-24. [PMID: 25116575 DOI: 10.3109/2000656x.2014.920710] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Desmoid tumours are uncommon non-malignant tumours that show a locally aggressive growth pattern and a high local recurrence rate after surgery. Approximately 10% of the desmoid tumours are associated with familial adenomatous polyposis (FAP). Variable natural history of the disease challenges treatment decision-making in the absence of prospective, randomised data. Association of this rare tumour to GIST is speculated and the tumorigenesis may share common steps. This study reviews given treatment and reports prognostic factors for local control and concurrent neoplasms in patients evaluated by a single soft tissue tumour group. Patients referred to the soft tissue tumour group at Helsinki University Central Hospital (HUCH) for a desmoid tumour (primary or recurred) during 1987-2007 and receiving surgical treatment with or without adjuvant treatment were included in this retrospective review. All locations and also patients with a FAP-associated tumour were included. Extra-abdominal location showed lower local control despite the fact that 27% of patients also received radiation therapy. One amputation was performed. Female sex and location in the rectus abdominis muscle predicted improved local control in multivariate analysis. In this review, the occurrence (14%) of concurrent neoplasms was higher than expected with unusual tumour types noted including two GISTs. In those patients in whom surgical treatment is chosen, adjuvant radiation therapy should also be considered in order to decrease morbidity from aggressive surgery aiming at R0 resection. Further studies are suggested to illuminate the biological association between the desmoid tumour and other neoplasms.
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Affiliation(s)
- Hanna R Ihalainen
- Department of Plastic Surgery, Helsinki University Central Hospital , Helsinki , Finland
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102
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Abstract
Bone and soft tissue tumor ablation has reached widespread acceptance in the locoregional treatment of various benign and malignant musculoskeletal (MSK) lesions. Many principles of ablation learned elsewhere in the body are easily adapted to the MSK system, particularly the various technical aspects of probe/antenna design, tumoricidal effects, selection of image guidance, and methods to reduce complications. Despite the common use of thermal and chemical ablation procedures in bone and soft tissues, there are few large clinical series that show longitudinal benefit and cost-effectiveness compared with conventional methods, namely, surgery, external beam radiation, and chemotherapy. Percutaneous radiofrequency ablation of osteoid osteomas has been evaluated the most and is considered a first-line treatment choice for many lesions. Palliation of painful metastatic bone disease with thermal ablation is considered safe and has been shown to reduce pain and analgesic use while improving quality of life for cancer patients. Procedure-related complications are rare and are typically easily managed. Similar to all interventional procedures, bone and soft tissue lesions require an integrated approach to disease management to determine the optimum type of and timing for ablation techniques within the context of the patient care plan.
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Affiliation(s)
- Ryan C B Foster
- Department of Radiology, Hospital for Special Surgery, New York, New York
| | - Joseph M Stavas
- Department of Radiology, the University of North Carolina, Chapel Hill, North Carolina
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Abstract
Desmoid fibromatosis is a benign yet locally aggressive tumor with a tendency to recur. It causes considerable morbidity particularly when it arises in a small area in the head and neck region. This tumor is extremely rare in the submandibular region. We report a case of desmoid tumor in the submandibular region in a 32-year-old male who presented with right submandibular swelling postextraction of right lower wisdom tooth. Excision biopsy was carried out initially following inconclusive fine needle aspiration and discussion at multidisciplinary meeting. The tumor recurred 4 months following initial excisional biopsy necessitating a more radical secondary approach involving segmental mandibulectomy. Intraoperatively we also noted that the tumor was originating from the site of previous wisdom tooth extraction, raising the question of surgical trauma as precursor of desmoid tumor. We achieved a negative resection margin and a complete remission for 24 months.
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Affiliation(s)
- Rohana Ali
- Department of Surgery, Perdana University- Royal College of Surgeons Ireland, Malaysia. Block B and D1, MAEPS building, MARDI Complex, Jalan MAEPS Perdana, 43400 Serdang, Selangor, Malaysia ; Department of Otorhinolaryngology, Head and Neck Surgery, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - Nirmalatiban Parthiban
- Department of Surgery, Perdana University- Royal College of Surgeons Ireland, Malaysia. Block B and D1, MAEPS building, MARDI Complex, Jalan MAEPS Perdana, 43400 Serdang, Selangor, Malaysia
| | - Tadgh O'Dwyer
- Department of Otorhinolaryngology, Head and Neck Surgery, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
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104
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Desmoid-type fibromatosis and pregnancy: a multi-institutional analysis of recurrence and obstetric risk. Ann Surg 2014; 259:973-8. [PMID: 24477160 DOI: 10.1097/sla.0000000000000224] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Many women who present with desmoid-type fibromatosis (DF) have had a recent pregnancy. Long-term data about disease behavior during and after pregnancy are lacking. OBJECTIVE To investigate the possible relationship between DF and pregnancy. PATIENTS AND METHODS A cohort of women with DF and pregnancy was identified from 4 sarcoma centers. Four groups were identified: diagnosis during pregnancy (A); diagnosis after delivery (B); DF clinically evident during pregnancy (C); and DF resected before pregnancy (D). Progression/regression rates, recurrence rates after resection, and obstetric outcomes were analyzed. RESULTS Ninety-two women were included. Forty-four women (48%) had pregnancy-related DF (A + B), whereas 48 (52%) had a history of DF before conception (C + D). Initial treatment was resection in 52%, medical therapy in 4%, and watchful waiting in 43%. Postsurgical relapse rate in A + B was 13%, although progression during watchful waiting was 63%. Relapse/progression in C + D was 42%. After pregnancy, 46% underwent treatment of DF, whereas 54% were managed with watchful waiting. Eventually, only 17% experienced further progression after treatment. Spontaneous regression occurred in 14%. After further pregnancies, only 27% progressed. The only related obstetric event was a cesarean delivery. CONCLUSIONS Pregnancy-related DF has good outcomes. Progression risk during pregnancy is high, but it can be safely managed. DF does not increase obstetric risk, and it should not be a contraindication to future pregnancy.
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105
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Zeng WG, Zhou ZX, Liang JW, Hou HR, Wang Z, Zhou HT, Zhang XM, Hu JJ. Prognostic factors for desmoid tumor: a surgical series of 233 patients at a single institution. Tumour Biol 2014; 35:7513-21. [PMID: 24789435 DOI: 10.1007/s13277-014-2002-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 04/22/2014] [Indexed: 02/06/2023] Open
Abstract
Desmoid tumors are rare soft tissue tumors with limited data on their management and prognosis. We sought to determine the rates of recurrence after surgery for desmoid tumors and analyze factors predictive of recurrence-free survival (RFS). From February 1976 to October 2011, 233 consecutive patients with desmoid tumors who underwent macroscopically complete resection were included in this study. Clinicopathologic and treatment characteristics were evaluated to determine predictors of recurrence. Patterns of presentation included primary (n = 156, 67.0 %) and locally recurrent (n = 77, 33.0 %) disease initially treated elsewhere. Most patients had a R0 resection (n = 169, 72.5 %). In addition to surgery, 43 (18.5 %) patients received radiotherapy and 10 (4.3 %) patients received systemic therapy. Median follow-up was 54 months; recurrence disease was observed in 62 (26.6 %) patients. The estimated 5- and 10-year RFS was 74.2 % (95 % confidence interval (CI), 68.3-80.1) and 70.7 % (95 % CI, 64.2-77.2), respectively. Factors associated with worse RFS were tumor size larger than 5 cm (hazard ratio (HR) = 3.757; 95 % CI, 1.945-7.259; p < 0.001), extra-abdominal tumor location (abdominal wall referent; HR = 3.373; 95 % CI, 1.425-7.984; p = 0.006), and R1 resection status (HR = 1.901; 95 % CI, 1.140-3.171; p = 0.014). Patients were grouped according to the number of unfavorable prognostic factors; the 10-year RFS rates of patients with zero, one, two, and three prognostic factors were 100, 86.9, 48.5, and 34.4 %, respectively (p < 0.001). Regardless of primary or recurrent disease, surgical resection remains central to the management of patients with desmoid tumors. However, there are clearly different prognostic subgroups that could benefit from different therapeutic strategies, and a wait-and-see policy is a possible option for a subset of patients.
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Affiliation(s)
- Wei-Gen Zeng
- Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 17 Panjiayuan Nanli, Chaoyang District, 100021, Beijing, China
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Hamada S, Futamura N, Ikuta K, Urakawa H, Kozawa E, Ishiguro N, Nishida Y. CTNNB1 S45F mutation predicts poor efficacy of meloxicam treatment for desmoid tumors: a pilot study. PLoS One 2014; 9:e96391. [PMID: 24788118 PMCID: PMC4006838 DOI: 10.1371/journal.pone.0096391] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 03/25/2014] [Indexed: 11/18/2022] Open
Abstract
We hypothesized that patterns of CTNNB1 (β-catenin) mutations would affect the outcome of conservative therapy in patients with desmoid tumors. This study aimed to determine the significance of CTNNB1 (β-catenin) mutations in predicting the treatment outcome in patients with desmoid tumors treated with meloxicam, a cyclooxygenase-2 (COX-2) selective inhibitor. Between 2003 and 2012, consecutive thirty-three patients with extra-peritoneal sporadic desmoid tumors were prospectively treated with meloxicam as the initial systemic medical therapy. The efficacy of meloxicam was evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST). DNA was isolated from frozen tissue or formalin-fixed materials. CTNNB1 mutation analysis was performed by direct sequencing. Positivity of nuclear β-catenin staining by immunohistochemistry was compared with the status of CTNNB1 mutations. The correlation between the efficacy of meloxicam treatment and status of CTNNB1 mutations was analyzed. Of the 33 patients with meloxicam treatment, one showed complete remission (CR), 7 partial remission (PR), 12 stable disease (SD), and 13 progressive disease (PD). The following 3 point mutations were identified in 21 of the 33 cases (64%): T41A (16 cases), S45F (4 cases) and S45P (one case). The nuclear expression of β-catenin correlated significantly with CTNNB1 mutation status (p = 0.035); all four cases with S45F mutation exhibited strong nuclear expression of β-catenin. S45F mutation was significantly associated with a poor response (all cases; PD) (p = 0.017), whereas the other mutations had no impact on efficacy. The CTNNB1 mutation status was of significant prognostic value for meloxicam treatment in patients with sporadic desmoid tumors.
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Affiliation(s)
- Shunsuke Hamada
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Japan
| | - Naohisa Futamura
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Japan
| | - Kunihiro Ikuta
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Japan
| | - Hiroshi Urakawa
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Japan
| | - Eiji Kozawa
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Japan
| | - Naoki Ishiguro
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Japan
| | - Yoshihiro Nishida
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Japan
- * E-mail:
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107
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Gronchi A, Colombo C, Raut CP. Surgical management of localized soft tissue tumors. Cancer 2014; 120:2638-48. [DOI: 10.1002/cncr.28715] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 03/07/2014] [Accepted: 03/11/2014] [Indexed: 11/09/2022]
Affiliation(s)
- Alessandro Gronchi
- Department of Surgery, Sarcoma Service; Scientific Institute for Research and Treatment (IRCCS) Foundation, National Cancer Institute; Milan Italy
| | - Chiara Colombo
- Department of Surgery, Sarcoma Service; Scientific Institute for Research and Treatment (IRCCS) Foundation, National Cancer Institute; Milan Italy
| | - Chandrajit P. Raut
- Department of Surgery, Brigham and Women's Hospital Center for Sarcoma and Bone Oncology; Dana-Farber Cancer Institute-Harvard Medical School; Boston Massachusetts
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108
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Wilkinson MJ, Chan KE, Hayes AJ, Strauss DC. Surgical Outcomes following Resection for Sporadic Abdominal Wall Fibromatosis. Ann Surg Oncol 2014; 21:2144-9. [DOI: 10.1245/s10434-014-3618-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Indexed: 11/18/2022]
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109
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Gronchi A, Colombo C, Le Péchoux C, Dei Tos AP, Le Cesne A, Marrari A, Penel N, Grignani G, Blay JY, Casali PG, Stoeckle E, Gherlinzoni F, Meeus P, Mussi C, Gouin F, Duffaud F, Fiore M, Bonvalot S. Sporadic desmoid-type fibromatosis: a stepwise approach to a non-metastasising neoplasm--a position paper from the Italian and the French Sarcoma Group. Ann Oncol 2014; 25:578-583. [PMID: 24325833 PMCID: PMC4433504 DOI: 10.1093/annonc/mdt485] [Citation(s) in RCA: 130] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 09/18/2013] [Accepted: 09/19/2013] [Indexed: 12/24/2022] Open
Abstract
Desmoid-type fibromatosis (DF) is a rare locally aggressive monoclonal proliferation of myofibroblasts lacking metastatic capacity. It may be observed in nearly every part of the body. Considering the variable clinical presentations, anatomic locations, and biologic behaviors, an individualized treatment approach is required. The pathogenesis of DF is not completely understood even if a high prevalence (∼85%) of CTNNB1 mutations discovered in sporadic DF underlies the importance of the Wnt/β-catenin pathway. No established and evidence-based approach for the treatment of this neoplasm is available as of today. Considering the unpredictable behavior and the heterogeneity of this disease, we propose a treatment algorithm approved by the French and the Italian Sarcoma Group, based on a front-line wait and see approach and subsequent therapy in the case of progression. A careful counseling at a referral center is mandatory and should be offered to all patients affected by sporadic DF from the time of their diagnosis.
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Affiliation(s)
- A Gronchi
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - C Colombo
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - C Le Péchoux
- Department of Radiation Oncology, Institute Gustave Roussy, Villejuif, France
| | - A P Dei Tos
- Department of Pathology, Treviso General Hospital, Treviso, Italy
| | - A Le Cesne
- Department of Cancer Medicine, Institute Gustave Roussy, Villejuif, France
| | - A Marrari
- Department of Cancer Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - N Penel
- Department of General Oncology, Centre Oscar Lambret, Lille, France
| | - G Grignani
- Department of Cancer Medicine, Institute for Cancer Research and Treatment at Candiolo, Torino, Italy
| | - J Y Blay
- Department of Cancer Medicine, Centre Leon Berard, Lyon
| | - P G Casali
- Department of Cancer Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - E Stoeckle
- Department of Surgery, Institut Bergonié, Regional Cancer Centre, Bordeaux, France
| | - F Gherlinzoni
- Department of Orthopedics, Gorizia General Hospital, Gorizia, Italy
| | - P Meeus
- Department of Surgery, Centre Leon Berard, Lyon, France
| | - C Mussi
- Department of Surgery, Humanitas Cancer Center, Rozzano, Italy
| | - F Gouin
- Department of Orthopedics, Centre Hospitalier Universitaire, Nantes
| | - F Duffaud
- Department of Medical Oncology, Marseille and Aix-Marseille University, Marseille
| | - M Fiore
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Bonvalot
- Department of Surgery, Institute Gustave Roussy, Villejuif, France
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110
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Eastley N, Aujla R, Silk R, Richards CJ, McCulloch TA, Esler CP, Ashford RU. Extra-abdominal desmoid fibromatosis--a sarcoma unit review of practice, long term recurrence rates and survival. Eur J Surg Oncol 2014; 40:1125-30. [PMID: 24612653 DOI: 10.1016/j.ejso.2014.02.226] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 02/08/2014] [Accepted: 02/10/2014] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Desmoid fibromatosis (DF) carries a significant morbidity and a recognised mortality. Despite this there are currently limited diagnostic or treatment algorithms specific to cases of extra-abdominal DF. Historically surgical excision has formed the cornerstone of treatment. Recently however a paradigm shift has meant many practitioners now adopt a more conservative approach, placing emphasis on active surveillance, function preserving resections, and non-surgical oncologic therapies. METHODS We performed an 8-year retrospective review of all cases of extra-abdominal DF managed within our region to assess the consistency of diagnostics, management and long-term outcome. RESULTS 47 eligible cases were identified. Mean age at diagnosis was 41.3 years (1-81 years). Disease location and speciality of diagnosing practitioners were varied. Management was generally inconsistent. Variation was seen in imaging, biopsy techniques, MDT involvement and management. At a median follow up of 4.9 years our local recurrence rate was 19%. DISCUSSION The optimal management of DF is unknown. This has led to a lack of formalised guidance for practitioners managing this challenging condition, resulting in inconsistencies and areas for improvement in current management. We propose a diagnostic pathway which may improve consistency of care, reduce potentially unnecessary surgery and the associated morbidity, and significantly increase the rate of complete (R0) surgical resections when surgery is deemed appropriate whilst not significantly worsening oncological outcome. Specifically we propose all cases should be imaged appropriately (usually with MRI), undergo a planned biopsy (by radiologically guided core needle biopsy) and be managed centrally in conjunction with multidisciplinary sarcoma units.
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Affiliation(s)
- N Eastley
- Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester LE1 5WW, United Kingdom.
| | - R Aujla
- Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester LE1 5WW, United Kingdom.
| | - R Silk
- Nottingham City Hospital, Nottingham University Hospitals NHS Trust, Hucknall Road, Nottingham NG5 1PB, United Kingdom.
| | - C J Richards
- Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester LE1 5WW, United Kingdom.
| | - T A McCulloch
- Nottingham City Hospital, Nottingham University Hospitals NHS Trust, Hucknall Road, Nottingham NG5 1PB, United Kingdom.
| | - C P Esler
- Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester LE1 5WW, United Kingdom; Nottingham City Hospital, Nottingham University Hospitals NHS Trust, Hucknall Road, Nottingham NG5 1PB, United Kingdom.
| | - R U Ashford
- Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester LE1 5WW, United Kingdom; Nottingham City Hospital, Nottingham University Hospitals NHS Trust, Hucknall Road, Nottingham NG5 1PB, United Kingdom; Academic Orthopaedics, Trauma & Sports Medicine, University of Nottingham, United Kingdom.
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111
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Hamada S, Urakawa H, Kozawa E, Futamura N, Ikuta K, Shimoyama Y, Nakamura S, Ishiguro N, Nishida Y. Nuclear expression of β-catenin predicts the efficacy of meloxicam treatment for patients with sporadic desmoid tumors. Tumour Biol 2014; 35:4561-6. [PMID: 24390670 DOI: 10.1007/s13277-013-1600-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 12/23/2013] [Indexed: 11/25/2022] Open
Abstract
This study aimed to determine the prevalence of β-catenin nuclear positivity as a prognostic factor in patients with desmoid tumors (DTs) treated with meloxicam, a cyclooxygenase-2 (COX-2) selective inhibitor. Between 2003 and 2012, consecutive 31 patients with extraabdominal, sporadic DTs were prospectively treated with meloxicam as a systemic medical therapy. Immunohistochemistry was performed on formalin-fixed material to quantify the nuclear expression of β-catenin and Ki-67, and cytoplasmic expression of COX-2. All clinicopathological characteristics including the intensity of immunohistochemical staining were analyzed with respect to their prognostic value for meloxicam treatment. Of the 31 patients with meloxicam treatment, there was 1 with complete remission (CR), 7 with partial remission (PR), 12 with stable disease (SD), and 11 with progressive disease (PD). Higher nuclear expression of β-catenin was significantly associated with a poor response (PD/SD) (p = 0.017). The positivity of COX-2 and Ki-67 and none of the other clinical variables were associated with prognosis. The nuclear expression of β-catenin can predict the efficacy of meloxicam treatment for patients with sporadic DTs.
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Affiliation(s)
- Shunsuke Hamada
- Department of Orthopedic Surgery, Nagoya University Graduate School and School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan
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Martin-Liberal J, Benson C, McCarty H, Thway K, Messiou C, Judson I. Pazopanib is an active treatment in desmoid tumour/aggressive fibromatosis. Clin Sarcoma Res 2013; 3:13. [PMID: 24279994 PMCID: PMC4176486 DOI: 10.1186/2045-3329-3-13] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 11/21/2013] [Indexed: 11/10/2022] Open
Abstract
Background Desmoid tumours/aggressive fibromatosis (DT/AF) are infrequent soft-tissue neoplasms. They usually behave as indolent diseases. However, they may grow locally infiltrating or compressing adjacent structures. The role of local treatment is limited and only a few drugs have shown activity. Cases presentation We report the outcome of two patients affected by progressive DT/AF treated with the angiogenesis inhibitor pazopanib in two different institutions. Both patients achieved dramatic improvement in their symptoms and radiological signs of response. The clinical benefit lasted for more than 1 year and it is still ongoing. Conclusions Pazopanib is an active treatment in DT/AF. It is the first time this has been reported.
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113
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Gyorki DE, Brennan MF. Management of recurrent retroperitoneal sarcoma. J Surg Oncol 2013; 109:53-9. [PMID: 24155163 DOI: 10.1002/jso.23463] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 09/10/2013] [Indexed: 01/01/2023]
Abstract
Approximately 15% of soft tissue sarcomas are retroperitoneal. The occult location and anatomic complexity results in local recurrences in the majority of patients. Predictors of recurrence include histological subtype, completeness of resection, and the hospital case volume. The most significant predictor of outcome following local recurrence is the resectability of the recurrent disease. An understanding of the implication of tumor biology on outcomes is essential in determining optimal management for patients with recurrent retroperitoneal sarcoma.
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Affiliation(s)
- David E Gyorki
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York
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115
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Keus R, Nout R, Blay JY, de Jong J, Hennig I, Saran F, Hartmann J, Sunyach M, Gwyther S, Ouali M, Kirkpatrick A, Poortmans P, Hogendoorn P, van der Graaf W. Results of a phase II pilot study of moderate dose radiotherapy for inoperable desmoid-type fibromatosis—an EORTC STBSG and ROG study (EORTC 62991–22998). Ann Oncol 2013; 24:2672-2676. [DOI: 10.1093/annonc/mdt254] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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116
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Bonvalot S, Ternès N, Fiore M, Bitsakou G, Colombo C, Honoré C, Marrari A, Le Cesne A, Perrone F, Dunant A, Gronchi A. Spontaneous Regression of Primary Abdominal Wall Desmoid Tumors: More Common than Previously Thought. Ann Surg Oncol 2013; 20:4096-102. [DOI: 10.1245/s10434-013-3197-x] [Citation(s) in RCA: 140] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Indexed: 12/27/2022]
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117
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119
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Galletto P, Leoz ML, Castells A, Balaguer F. [Intraabdominal desmoid tumors in familial adenomatous polyposis]. GASTROENTEROLOGIA Y HEPATOLOGIA 2013; 36:580-6. [PMID: 23541808 DOI: 10.1016/j.gastrohep.2012.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 12/27/2012] [Indexed: 10/27/2022]
Abstract
Desmoid tumors are currently the main cause of morbidity and mortality in patients with familial adenomatous polyposis. More than 10% of these patients will develop these tumors during their lifetime and more than a third will suffer their consequences. The main risk factors for their development are female sex and abdominal surgery. The most frequent localization is intraabdominal. The therapeutic approach to these tumors has changed, and the surgical treatment of choice is currently the subject of debate. If a watch and wait approach is adopted, more than 50% of tumors will prove to be indolent. Therefore, the therapeutic strategy should be based on clinical presentation and should be decided by a multidisciplinary team working in a center with experience of these tumors. The present article proposes a prognostic classification to guide the therapeutic approach.
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Affiliation(s)
- Paula Galletto
- Servicio de Gastroenterología, Hospital Clínic, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), IDIBAPS, Universidad de Barcelona, Barcelona, España
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