Multimodality treatment in the control of deep musculoaponeurotic fibromatosis.

BACKGROUND

Deep musculoaponeurotic fibromatoses are rare soft tissue neoplasms with a propensity for local recurrence.

METHODS

A retrospective analysis was carried out of the factors contributing to local disease control in 75 patients treated between 1963 and 1993.

RESULTS

Multivariate analysis identified the type of surgical excision (P < 0.001) and involvement of pathological resection margins (P < 0.02) as significant factors contributing to local recurrence. After a median follow up of 47 months (range 24 months to 29 years) 31 (49 per cent) of the 63 patients who had an 'adequate' surgical resection developed local recurrence. The median time before development of local recurrence was 83.4 (range 8-129) months in patients with clear pathological resection margins. This was significantly shortened to 13.1 (range 2-35) months in those with positive margins (P < 0.001).

CONCLUSION

Adequate surgical extirpation is the most important determinant in local disease control. Treatment of local recurrence ranged from observation during periods of disease stabilization to multimodality treatment for aggressive disease.