Rock M G, Pritchard D J, Reiman H M, Soule E H, Brewster R C
J Bone Joint Surg Am. 1984 Dec;66(9):1369-74.
One hundred and ninety-four patients with extra-abdominal desmoid tumors, most of them in the extremities, have been treated at the Mayo Clinic. One hundred and thirty-two patients (68 per cent) experienced a recurrence at an average of 1.4 years after the first treatment. A greater tendency for recurrence was evident in female patients, in patients who were more than thirty years old, in certain anatomical locations (especially the foot and calf), and most importantly after treatment by intralesional or marginal excision. In view of the excellent prognosis for survival, we recommend wide local excision when anatomically feasible or marginal excision and postoperative radiation therapy when function of the extremity would be severely compromised if excision with wide margins were done. A recurrent lesion that does not appear to be growing should be followed until evidence of growth of the lesion precipitates a secondary wide excision.
梅奥诊所共治疗了194例腹外硬纤维瘤患者，其中大多数位于四肢。132例患者（68%）在首次治疗后平均1.4年出现复发。女性患者、30岁以上患者、某些解剖部位（尤其是足部和小腿）复发倾向更明显，最重要的是在采用病损内或边缘切除术后复发倾向更明显。鉴于生存预后良好，如果在解剖学上可行，我们建议行广泛局部切除；如果行广泛边缘切除会严重损害肢体功能，则建议行边缘切除及术后放疗。对于似乎没有生长的复发病变，应进行随访，直到病变生长的证据促使进行二次广泛切除。
