Aggressive fibromatosis - surgical approach as a part of combined treatment

Aim of the study. To evaluate results of surgery alone in the treatment of aggressive fibromatosis during past 4 years. Materials and methods. From January 2006 till January 2010 in the dept, of orthopedic surgery 32 patients with extra abdominal aggressive fibromatosis underwent 38 surgeries (6 patients received additional surgeries due to local relapses). 9 male (28%) and 23 (72%) female patients were included in the trial. Median age was 31 year (16-70 y.o.). 12 patients (37,5%) out of 32 were with primary tumor, 18 (56%) with relapse tumors and 2 (6,5%) patients with undefinitive surgery made elsewhere. 12 (37%) patients out 32 underwent preplanned bone resections and 11 reconstructive surgery was done. Results. In 12 (31%) pathology reported positive margins (Rl) and the wrest were R0. 11 patients had disease progression 3 to 18 month after the surgery, 4 patients were lost of follow up. 7 patients are undergoing conservative treatment for tumor recurrence. 21 (66%) patient is alive without progression with follow up from 3 to 49 month (median follow up 17 months). Following negative prognostic factors were observed: multifocal tumor growth, tumor volume more then 1000 cm³, tumor location near the joints, in soft tissues of forearm, arm, hand, lower leg and foot. Conclusion. Negative margins does not guarantee that tumor will not relapse even with addition of RT or/and chemotherapy and in opposite, sometimes in patients with positive margins recurrence is not observed.

aggressive fibromatosis, tumor margins, local recurrence

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