Title :

Surgical versus non-surgical approach in primary desmoid-type fibromatosis patients: a nationwide prospective cohort from the french sarcoma group

Author(s) :

Penel, Nicolas [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Le Cesne, Axel [Auteur]
Bonvalot, Sylvie [Auteur]
Giraud, Antoine [Auteur]
Bompas, Emmanuelle [Auteur]
Rios, Maria [Auteur]
Salas, Sébastien [Auteur]
Isambert, Nicolas [Auteur]
Boudou-Rouquette, Pascaline [Auteur]
Honore, Charles [Auteur]
Italiano, Antoine [Auteur]
Ray-Coquard, Isabelle [Auteur]
Piperno-Neumann, Sophie [Auteur]
Gouin, François [Auteur]
Bertucci, François [Auteur]
Ryckewaert, Thomas [Auteur]
Kurtz, Jean-Emmanuel [Auteur]
Ducimetiere, Françoise [Auteur]
Coindre, Jean-Michel [Auteur]
Blay, Jean-Yves [Auteur]

Journal title :

European journal of cancer (Oxford, England . 1990)

Abbreviated title :

Eur. J. Cancer

Volume number :

83

Pages :

125-131

Publication date :

2017-09-01

ISSN :

0959-8049

English keyword(s) :

Wait and see
Surgery
Prognostic factors
Nationwide cohort
Desmoid-type fibomatosis

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

The outcome of desmoid-type fibromatosis (DTF) is unpredictable. Currently, a wait-and-see approach tends to replace large en bloc resection as the first therapeutic approach. Nevertheless, there are no validated factors ...
Show more >The outcome of desmoid-type fibromatosis (DTF) is unpredictable. Currently, a wait-and-see approach tends to replace large en bloc resection as the first therapeutic approach. Nevertheless, there are no validated factors to guide the treatment choice. We conducted a prospective study of 771 confirmed cases of DTF. We analysed event-free survival (EFS) based on the occurrence of relapse after surgery, progressive disease during the wait-and-see approach, or change in therapeutic strategy. Identification of prognostic factors was performed using classical methods (log-rank test and Cox model). Overall, the 2-year EFS was 56%; this value did not differ between patients undergoing an operation and those managed by the wait-and-see approach (53% versus 58%, p = 0.415). In univariate analysis, two prognostic factors significantly influenced the outcome: the nature of diagnostic sampling (p = 0.466) and primary location (p = 0.0001). The 2-year EFS was only 32% after open biopsy. The 2-year EFS was 66% for favourable locations (abdominal wall, intra-abdominal, breast, digestive viscera and lower limb) and 41% for unfavourable locations. Among patients with favourable locations, the 2-year EFS was similar in patients treated by both surgery (70%) and the wait-and-see approach (63%; p = 0.413). Among patients with unfavourable locations, the 2-year EFS was significantly enhanced in patients initially managed with the wait-and-see approach (52%) compared with those who underwent initial surgery (25%; p = 0.001). The location of DTF is a major prognostic factor for EFS. If these findings are confirmed by independent analysis, personalised management of DTF must consider this easily obtained parameter.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Université de Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2019-12-09T18:17:07Z