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Management of Patients with Newly Diagnosed Desmoid Tumors in a First-Line Setting.
Testa, Stefano; Bui, Nam Q; Charville, Gregory W; Avedian, Raffi S; Steffner, Robert; Ghanouni, Pejman; Mohler, David G; Ganjoo, Kristen N.
Afiliación
  • Testa S; Department of Medicine, Stanford University, Stanford, CA 94304, USA.
  • Bui NQ; Division of Oncology, Department of Medicine, Stanford University, Stanford, CA 94304, USA.
  • Charville GW; Department of Pathology, Stanford University, Stanford, CA 94304, USA.
  • Avedian RS; Department of Orthopedic Surgery, Stanford University, Redwood City, CA 94063, USA.
  • Steffner R; Department of Orthopedic Surgery, Stanford University, Redwood City, CA 94063, USA.
  • Ghanouni P; Department of Radiology, Stanford University, Stanford, CA 94304, USA.
  • Mohler DG; Department of Orthopedic Surgery, Stanford University, Redwood City, CA 94063, USA.
  • Ganjoo KN; Division of Oncology, Department of Medicine, Stanford University, Stanford, CA 94304, USA.
Cancers (Basel) ; 14(16)2022 Aug 12.
Article en En | MEDLINE | ID: mdl-36010900
The initial management of desmoid tumors (DTs) is shifting from surgery towards active surveillance, with systemic and locally ablative treatments reserved for enlarging and/or symptomatic disease. However, it remains unclear which patients would benefit most from an initial conservative rather than interventional approach. To answer this question, we retrospectively analyzed adult and pediatric patients with DTs treated at a tertiary academic cancer center between 1992 and 2022. Outcomes measured were progression-free survival (PFS) and time to next treatment (TTNT) after first-line therapy. A total of 262 treatment-naïve patients were eligible for analysis with a median age of 36.5 years (range, 0−87 years). The 5-year PFS and the median TTNT (months) after first-line treatment were, respectively: 50.6% and 69.1 mo for surgery; 64.9% and 149.5 mo for surgery plus adjuvant radiotherapy; 57.1% and 44.7 mo for surgery plus adjuvant systemic therapy; 24.9% and 4.4 mo for chemotherapy; 26.7% and 5.3 mo for hormonal therapy; 41.3% and 29.6 mo for tyrosine kinase inhibitors (TKIs); 44.4% and 8.9 mo for cryoablation and high intensity focused ultrasound; and 43.1% and 32.7 mo for active surveillance. Age ≤ 40 years (p < 0.001), DTs involving the extremities (p < 0.001), a maximum tumor diameter > 60 mm (p = 0.04), and hormonal therapy (p = 0.03) predicted a higher risk of progression. Overall, our results suggest that active surveillance should be considered initially for patients with smaller asymptomatic DTs, while upfront TKIs, local ablation, and surgery achieve similar outcomes in those with more aggressive disease.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies / Prognostic_studies Idioma: En Revista: Cancers (Basel) Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies / Prognostic_studies Idioma: En Revista: Cancers (Basel) Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza