Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan.
Department of Rehabilitation Medicine, Nagoya University Hospital, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan.
Int J Clin Oncol. 2019 Nov;24(11):1498-1505. doi: 10.1007/s10147-019-01512-z. Epub 2019 Jul 22.
Treatment modality of desmoid-type fibromatosis (DF) has changed from surgery with a wide surgical margin to conservative treatment. In this study, tumor characteristics of DF, transition of the treatment modality, and clinical outcome of surgical treatment were analyzed based on data obtained from the bone and soft tissue tumor registry established in Japan.
Data were collected as registration data and follow-up data. Five hundred and thirty registered cases of DF were identified, including 223 cases with follow-up data with or without surgical treatment.
The number of registered patients increased gradually. The frequency of surgical treatment was gradually reduced year by year. The 3-year local recurrence free survival (LRFS) was 77.7%, with tumor location and size tending to correlate with LRFS. Interestingly, there was no significant difference in LRFS between wide and marginal margin (P = 0.34).
The treatment modality has shifted from surgical to conservative treatment, with risk factors for surgical treatment similar to those noted in previous studies. The National registry system is crucial for a rare disease such as DF, and in the future, a population based registry system should be established to better comprehend the actual status of DF.
硬纤维瘤(desmoid-type fibromatosis,DF)的治疗方式已经从广泛切除的手术治疗转变为保守治疗。本研究基于日本建立的骨与软组织肿瘤登记系统,分析了 DF 的肿瘤特征、治疗方式的转变以及手术治疗的临床结果。
数据作为登记数据和随访数据进行收集。共登记了 530 例 DF 患者,其中 223 例有手术治疗或不治疗的随访数据。
登记患者的数量逐渐增加。手术治疗的频率逐年降低。3 年局部无复发生存率(LRFS)为 77.7%,肿瘤位置和大小与 LRFS 相关。有趣的是,广泛切除和边缘切除的 LRFS 无显著差异(P=0.34)。
治疗方式已从手术治疗转变为保守治疗,手术治疗的风险因素与既往研究相似。对于 DF 等罕见疾病,国家登记系统至关重要,未来应建立基于人群的登记系统,以更好地了解 DF 的实际情况。