Meta‐analysis of the influence of surgical margin and adjuvant radiotherapy on local recurrence after resection of sporadic desmoid‐type fibromatosis
Background Extra‐abdominal desmoid‐type fibromatosis (DF) is a rare, locally aggressive neoplasm that is usually managed conservatively. When treatment is indicated, it typically involves surgical resection, possibly with adjuvant radiotherapy. The indications for postoperative radiotherapy and its...
Gespeichert in:
| Veröffentlicht in: | British journal of surgery 2017-03, Vol.104 (4), p.347-357 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 357 |
|---|---|
| container_issue | 4 |
| container_start_page | 347 |
| container_title | British journal of surgery |
| container_volume | 104 |
| creator | Janssen, M. L. van Broekhoven, D. L. M. Cates, J. M. M. Bramer, W. M. Nuyttens, J. J. Gronchi, A. Salas, S. Bonvalot, S. Grünhagen, D. J. Verhoef, C. |
| description | Background
Extra‐abdominal desmoid‐type fibromatosis (DF) is a rare, locally aggressive neoplasm that is usually managed conservatively. When treatment is indicated, it typically involves surgical resection, possibly with adjuvant radiotherapy. The indications for postoperative radiotherapy and its effectiveness are unclear. The objective of this study was to estimate the effect of surgical resection margins and adjuvant radiotherapy on rates of recurrence of DF.
Methods
Literature published between 1999 and 2015 was extracted from MEDLINE, Embase, Cochrane Central Registry of Trials, Web of Science and Google Scholar. Recurrence rate was analysed by meta‐analysis and compared between subgroups.
Results
Sixteen reports were included, consisting of a total of 1295 patients with DF. In patients treated by surgical resection alone, the risk of local recurrence was almost twofold higher for those with microscopically positive resection margins (risk ratio (RR) 1·78, 95 per cent c.i. 1·40 to 2·26). Adjuvant radiotherapy after surgery with negative margins had no detectable benefit on recurrence. In contrast, after incomplete surgical resection, adjuvant radiotherapy improved recurrence rates both in patients with primary tumours (RR 1·54, 1·05 to 2·27) and in those with recurrent DF (RR 1·60, 1·12 to 2·28).
Conclusion
DF resected with microscopically positive margins has a higher risk of recurrence. Adjuvant radiotherapy appears to reduce the risk of recurrence after incomplete surgical resection, particularly in patients with recurrent tumours.
Radiotherapy after surgery for recurrence only |
| doi_str_mv | 10.1002/bjs.10477 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_1868694798</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4313936691</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4137-1545f65968144c16b48493749529117197cecaffae54cef8832960a9e02a79863</originalsourceid><addsrcrecordid>eNp9kc1u1TAQhS0EoreFBS-ALLFhc6nHdhJ7CVX5qYpYAGvL1xmDr5I42ElRdn2Ebnk9ngTntmXBgoXlo_E3R-M5hDwD9goY46e7fS5CNs0DsgFRV1sOtXpINoyxZguCiyNynPOeMRCs4o_JEVegNQO5Ib8-4mR_X9_YwXZLDplGT6fvSMPguxkHh2shz-lbcLajvS1ioHZoqW3385UdJppsG2JpSXZcaBxoF1cyoZtTOhhYP2EqhYxuCgVYDce4tjnaYu5jaMsA0zIi9WGXYm-nWCZ5Qh5522V8enefkK9vz7-cvd9efnr34ez15dZJEOV7lax8XelagZQO6p1UUotG6oprgAZ049BZ7y1W0qFXSnBdM6uRcdtoVYsT8vLWd0zxx4x5Mn3IDrvODhjnbEDVqtaysAV98Q-6j3Mqm8uGM6U4rH7_o1YvXg7wQj2_o-Zdj60ZUyjbXcx9NAU4vQV-hg6Xv-_AzJq5KZmbQ-bmzcXngxB_ADQ0oMc</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1868286812</pqid></control><display><type>article</type><title>Meta‐analysis of the influence of surgical margin and adjuvant radiotherapy on local recurrence after resection of sporadic desmoid‐type fibromatosis</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Janssen, M. L. ; van Broekhoven, D. L. M. ; Cates, J. M. M. ; Bramer, W. M. ; Nuyttens, J. J. ; Gronchi, A. ; Salas, S. ; Bonvalot, S. ; Grünhagen, D. J. ; Verhoef, C.</creator><creatorcontrib>Janssen, M. L. ; van Broekhoven, D. L. M. ; Cates, J. M. M. ; Bramer, W. M. ; Nuyttens, J. J. ; Gronchi, A. ; Salas, S. ; Bonvalot, S. ; Grünhagen, D. J. ; Verhoef, C.</creatorcontrib><description>Background
Extra‐abdominal desmoid‐type fibromatosis (DF) is a rare, locally aggressive neoplasm that is usually managed conservatively. When treatment is indicated, it typically involves surgical resection, possibly with adjuvant radiotherapy. The indications for postoperative radiotherapy and its effectiveness are unclear. The objective of this study was to estimate the effect of surgical resection margins and adjuvant radiotherapy on rates of recurrence of DF.
Methods
Literature published between 1999 and 2015 was extracted from MEDLINE, Embase, Cochrane Central Registry of Trials, Web of Science and Google Scholar. Recurrence rate was analysed by meta‐analysis and compared between subgroups.
Results
Sixteen reports were included, consisting of a total of 1295 patients with DF. In patients treated by surgical resection alone, the risk of local recurrence was almost twofold higher for those with microscopically positive resection margins (risk ratio (RR) 1·78, 95 per cent c.i. 1·40 to 2·26). Adjuvant radiotherapy after surgery with negative margins had no detectable benefit on recurrence. In contrast, after incomplete surgical resection, adjuvant radiotherapy improved recurrence rates both in patients with primary tumours (RR 1·54, 1·05 to 2·27) and in those with recurrent DF (RR 1·60, 1·12 to 2·28).
Conclusion
DF resected with microscopically positive margins has a higher risk of recurrence. Adjuvant radiotherapy appears to reduce the risk of recurrence after incomplete surgical resection, particularly in patients with recurrent tumours.
Radiotherapy after surgery for recurrence only</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1002/bjs.10477</identifier><identifier>PMID: 28199014</identifier><identifier>CODEN: BJSUAM</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Fibromatosis, Abdominal - radiotherapy ; Fibromatosis, Abdominal - surgery ; Humans ; Margins of Excision ; Meta-analysis ; Neoplasm Recurrence, Local - etiology ; Radiation therapy ; Radiotherapy, Adjuvant ; Risk Factors ; Treatment Outcome ; Tumors</subject><ispartof>British journal of surgery, 2017-03, Vol.104 (4), p.347-357</ispartof><rights>2017 BJS Society Ltd Published by John Wiley & Sons Ltd</rights><rights>2017 BJS Society Ltd Published by John Wiley & Sons Ltd.</rights><rights>Copyright © 2017 BJS Society Ltd. Published by John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4137-1545f65968144c16b48493749529117197cecaffae54cef8832960a9e02a79863</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fbjs.10477$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fbjs.10477$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28199014$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Janssen, M. L.</creatorcontrib><creatorcontrib>van Broekhoven, D. L. M.</creatorcontrib><creatorcontrib>Cates, J. M. M.</creatorcontrib><creatorcontrib>Bramer, W. M.</creatorcontrib><creatorcontrib>Nuyttens, J. J.</creatorcontrib><creatorcontrib>Gronchi, A.</creatorcontrib><creatorcontrib>Salas, S.</creatorcontrib><creatorcontrib>Bonvalot, S.</creatorcontrib><creatorcontrib>Grünhagen, D. J.</creatorcontrib><creatorcontrib>Verhoef, C.</creatorcontrib><title>Meta‐analysis of the influence of surgical margin and adjuvant radiotherapy on local recurrence after resection of sporadic desmoid‐type fibromatosis</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Background
Extra‐abdominal desmoid‐type fibromatosis (DF) is a rare, locally aggressive neoplasm that is usually managed conservatively. When treatment is indicated, it typically involves surgical resection, possibly with adjuvant radiotherapy. The indications for postoperative radiotherapy and its effectiveness are unclear. The objective of this study was to estimate the effect of surgical resection margins and adjuvant radiotherapy on rates of recurrence of DF.
Methods
Literature published between 1999 and 2015 was extracted from MEDLINE, Embase, Cochrane Central Registry of Trials, Web of Science and Google Scholar. Recurrence rate was analysed by meta‐analysis and compared between subgroups.
Results
Sixteen reports were included, consisting of a total of 1295 patients with DF. In patients treated by surgical resection alone, the risk of local recurrence was almost twofold higher for those with microscopically positive resection margins (risk ratio (RR) 1·78, 95 per cent c.i. 1·40 to 2·26). Adjuvant radiotherapy after surgery with negative margins had no detectable benefit on recurrence. In contrast, after incomplete surgical resection, adjuvant radiotherapy improved recurrence rates both in patients with primary tumours (RR 1·54, 1·05 to 2·27) and in those with recurrent DF (RR 1·60, 1·12 to 2·28).
Conclusion
DF resected with microscopically positive margins has a higher risk of recurrence. Adjuvant radiotherapy appears to reduce the risk of recurrence after incomplete surgical resection, particularly in patients with recurrent tumours.
Radiotherapy after surgery for recurrence only</description><subject>Fibromatosis, Abdominal - radiotherapy</subject><subject>Fibromatosis, Abdominal - surgery</subject><subject>Humans</subject><subject>Margins of Excision</subject><subject>Meta-analysis</subject><subject>Neoplasm Recurrence, Local - etiology</subject><subject>Radiation therapy</subject><subject>Radiotherapy, Adjuvant</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1TAQhS0EoreFBS-ALLFhc6nHdhJ7CVX5qYpYAGvL1xmDr5I42ElRdn2Ebnk9ngTntmXBgoXlo_E3R-M5hDwD9goY46e7fS5CNs0DsgFRV1sOtXpINoyxZguCiyNynPOeMRCs4o_JEVegNQO5Ib8-4mR_X9_YwXZLDplGT6fvSMPguxkHh2shz-lbcLajvS1ioHZoqW3385UdJppsG2JpSXZcaBxoF1cyoZtTOhhYP2EqhYxuCgVYDce4tjnaYu5jaMsA0zIi9WGXYm-nWCZ5Qh5522V8enefkK9vz7-cvd9efnr34ez15dZJEOV7lax8XelagZQO6p1UUotG6oprgAZ049BZ7y1W0qFXSnBdM6uRcdtoVYsT8vLWd0zxx4x5Mn3IDrvODhjnbEDVqtaysAV98Q-6j3Mqm8uGM6U4rH7_o1YvXg7wQj2_o-Zdj60ZUyjbXcx9NAU4vQV-hg6Xv-_AzJq5KZmbQ-bmzcXngxB_ADQ0oMc</recordid><startdate>201703</startdate><enddate>201703</enddate><creator>Janssen, M. L.</creator><creator>van Broekhoven, D. L. M.</creator><creator>Cates, J. M. M.</creator><creator>Bramer, W. M.</creator><creator>Nuyttens, J. J.</creator><creator>Gronchi, A.</creator><creator>Salas, S.</creator><creator>Bonvalot, S.</creator><creator>Grünhagen, D. J.</creator><creator>Verhoef, C.</creator><general>John Wiley & Sons, Ltd</general><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201703</creationdate><title>Meta‐analysis of the influence of surgical margin and adjuvant radiotherapy on local recurrence after resection of sporadic desmoid‐type fibromatosis</title><author>Janssen, M. L. ; van Broekhoven, D. L. M. ; Cates, J. M. M. ; Bramer, W. M. ; Nuyttens, J. J. ; Gronchi, A. ; Salas, S. ; Bonvalot, S. ; Grünhagen, D. J. ; Verhoef, C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4137-1545f65968144c16b48493749529117197cecaffae54cef8832960a9e02a79863</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Fibromatosis, Abdominal - radiotherapy</topic><topic>Fibromatosis, Abdominal - surgery</topic><topic>Humans</topic><topic>Margins of Excision</topic><topic>Meta-analysis</topic><topic>Neoplasm Recurrence, Local - etiology</topic><topic>Radiation therapy</topic><topic>Radiotherapy, Adjuvant</topic><topic>Risk Factors</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Janssen, M. L.</creatorcontrib><creatorcontrib>van Broekhoven, D. L. M.</creatorcontrib><creatorcontrib>Cates, J. M. M.</creatorcontrib><creatorcontrib>Bramer, W. M.</creatorcontrib><creatorcontrib>Nuyttens, J. J.</creatorcontrib><creatorcontrib>Gronchi, A.</creatorcontrib><creatorcontrib>Salas, S.</creatorcontrib><creatorcontrib>Bonvalot, S.</creatorcontrib><creatorcontrib>Grünhagen, D. J.</creatorcontrib><creatorcontrib>Verhoef, C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Janssen, M. L.</au><au>van Broekhoven, D. L. M.</au><au>Cates, J. M. M.</au><au>Bramer, W. M.</au><au>Nuyttens, J. J.</au><au>Gronchi, A.</au><au>Salas, S.</au><au>Bonvalot, S.</au><au>Grünhagen, D. J.</au><au>Verhoef, C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Meta‐analysis of the influence of surgical margin and adjuvant radiotherapy on local recurrence after resection of sporadic desmoid‐type fibromatosis</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>2017-03</date><risdate>2017</risdate><volume>104</volume><issue>4</issue><spage>347</spage><epage>357</epage><pages>347-357</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><coden>BJSUAM</coden><abstract>Background
Extra‐abdominal desmoid‐type fibromatosis (DF) is a rare, locally aggressive neoplasm that is usually managed conservatively. When treatment is indicated, it typically involves surgical resection, possibly with adjuvant radiotherapy. The indications for postoperative radiotherapy and its effectiveness are unclear. The objective of this study was to estimate the effect of surgical resection margins and adjuvant radiotherapy on rates of recurrence of DF.
Methods
Literature published between 1999 and 2015 was extracted from MEDLINE, Embase, Cochrane Central Registry of Trials, Web of Science and Google Scholar. Recurrence rate was analysed by meta‐analysis and compared between subgroups.
Results
Sixteen reports were included, consisting of a total of 1295 patients with DF. In patients treated by surgical resection alone, the risk of local recurrence was almost twofold higher for those with microscopically positive resection margins (risk ratio (RR) 1·78, 95 per cent c.i. 1·40 to 2·26). Adjuvant radiotherapy after surgery with negative margins had no detectable benefit on recurrence. In contrast, after incomplete surgical resection, adjuvant radiotherapy improved recurrence rates both in patients with primary tumours (RR 1·54, 1·05 to 2·27) and in those with recurrent DF (RR 1·60, 1·12 to 2·28).
Conclusion
DF resected with microscopically positive margins has a higher risk of recurrence. Adjuvant radiotherapy appears to reduce the risk of recurrence after incomplete surgical resection, particularly in patients with recurrent tumours.
Radiotherapy after surgery for recurrence only</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>28199014</pmid><doi>10.1002/bjs.10477</doi><tpages>11</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0007-1323 |
| ispartof | British journal of surgery, 2017-03, Vol.104 (4), p.347-357 |
| issn | 0007-1323 1365-2168 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1868694798 |
| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Fibromatosis, Abdominal - radiotherapy Fibromatosis, Abdominal - surgery Humans Margins of Excision Meta-analysis Neoplasm Recurrence, Local - etiology Radiation therapy Radiotherapy, Adjuvant Risk Factors Treatment Outcome Tumors |
| title | Meta‐analysis of the influence of surgical margin and adjuvant radiotherapy on local recurrence after resection of sporadic desmoid‐type fibromatosis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-29T01%3A39%3A09IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Meta%E2%80%90analysis%20of%20the%20influence%20of%20surgical%20margin%20and%20adjuvant%20radiotherapy%20on%20local%20recurrence%20after%20resection%20of%20sporadic%20desmoid%E2%80%90type%20fibromatosis&rft.jtitle=British%20journal%20of%20surgery&rft.au=Janssen,%20M.%20L.&rft.date=2017-03&rft.volume=104&rft.issue=4&rft.spage=347&rft.epage=357&rft.pages=347-357&rft.issn=0007-1323&rft.eissn=1365-2168&rft.coden=BJSUAM&rft_id=info:doi/10.1002/bjs.10477&rft_dat=%3Cproquest_pubme%3E4313936691%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1868286812&rft_id=info:pmid/28199014&rfr_iscdi=true |