Extra abdominal fibromatosis: should we change ?

Seance of wednesday 31 january 2007 (pas de sujet Principal)

Abstract

The objective of this study on patients with primary aggressivefibromatosis was to evaluate the impact of surgery as first-line treatmenton event -free survival (EFS). 3-year EFS after non surgicalstrategies, including medical treatment or a watch and wait policy,was similar to that of R0 resection (68% and 65% respectively). Incontrast, marginal resection had a statistically significant deleteriousimpact compared to non surgical strategies or R0 resection. Inthe multivariate analysis, the location remained the most importantpredictor of relapsing locally. There is however, a strong directrelationship between the location and the quality of surgery. Theseresults suggest that a less aggressive local strategy may be consideredfirst, and is an alternative in situations where surgery wouldresult in major functional or cosmetic defects. When surgery isfinally necessary, it should be performed with the aim of achievingnegative margins. It might be possible that biological markers foraggressive tumors could be identified and patients with a poor outcomecould be selected in the future through biological analysis. Aprospective clinical trial with bio-clinical correlations is ongoing.