Risk factors for local recurrence of fibromatosis
Machado V (1), Troncoso S (2), Mejías L (3), Idoate MÁ (3), San-Julián M (2).
(1) Departamento de Cirugía Ortopédica y Traumatología, Clínica Universidad de Navarra, Pamplona, Navarra, España.
(2) Departamento de Cirugía Ortopédica y Traumatología, Clínica Universidad de Navarra, Pamplona, Navarra, España.
(3) Departamento de Anatomía Patológica, Clínica Universidad de Navarra, Pamplona, Navarra, España.
Magazine: Revista Española de Cirugía Ortopédica y Traumatología
Date: Mar 31, 2017Pathological Anatomy [SP] Orthopedic Surgery and Traumatology [SP]
To evaluate the clinical, radiological and histological factors that can predict local recurrence of fibromatosis.
A retrospective study was conducted on 51 patients diagnosed with fibromatosis in this hospital from 1983 to 2014. The mean follow-up was 83 months. A study was made of the clinical parameters, location, depth, size, surgical margins, and proliferation index (Ki-67). An evaluation was also made of the risk of recurrence depending on the adjuvant treatment and the relationship between treatment and patient functionality.
Tumour location and depth were identified as risk factors for local recurrence, showing statistically significant differences (P<.001 and P=.003, respectively).
There were no statistically significant differences in age, gender, size, surgical margins, or adjuvant treatments, or in the Musculoskeletal Tumour Society Score according to the treatment received. The mean Ki-67 was 1.9% (range 1-4), and its value was not associated with the risk of recurrence.
Deep fibromatosis fascia tumours, and those located in extremities are more aggressive than superficial tumours and those located in trunk. The Ki-67 has no predictive value in local recurrence of fibromatosis. Radiotherapy, chemotherapy, or other adjuvant treatments such as tamoxifen have not been effective in local control of the disease.
Given the high recurrence rate, even with adequate margins, a wait and see attitude should be considered in asymptomatic patients and/or stable disease.
CITATION Rev Esp Cir Ortop Traumatol. 2017 Mar - Apr;61(2):82-87. doi: 10.1016/j.recot.2016.12.001. Epub 2017 Feb 21
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