Open AccessRisk factors of local recurrence after surgery in extraabdominal desmoid‐type fibromatosis: A multicenter study in Japan
Author(s) -
Nishida Yoshihiro,
Hamada Shunsuke,
Kawai Akira,
Kunisada Toshiyuki,
Ogose Akira,
Matsumoto Yoshihiro,
Ae Keisuke,
Toguchida Junya,
Ozaki Toshifumi,
Hirakawa Akihiro,
Motoi Toru,
Sakai Tomohisa,
Kobayashi Eisuke,
Gokita Tabu,
Okamoto Takeshi,
Matsunobu Tomoya,
Shimizu Koki,
Koike Hiroshi
Publication year - 2020
Publication title -
cancer science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.035
H-Index - 141
eISSN - 1349-7006
pISSN - 1347-9032
DOI - 10.1111/cas.14528
Subject(s) - medicine , fibromatosis , incidence (geometry) , univariate analysis , surgical margin , adverse effect , medical record , risk factor , soft tissue , disease , multivariate analysis , surgery , oncology , cancer , physics , optics
This study was undertaken to clarify the risk factors, including the mutation status of CTNNB1 , for the local recurrence after surgery of the rare disease desmoid‐type fibromatosis. It was designed as a multiinstitutional joint research project with 7 major centers in Japan participating. The committee members of 7 major medical centers specializing in bone and soft tissue tumors formed this study group to develop clinical care guidelines. Of 196 cases with specimens and medical records collected from the 7 institutions, 88 surgically treated ones were analyzed regarding clinicopathologic prognostic factors including CTNNB1 mutation status. Excluding R2 cases (n = 3), 5‐year local recurrence‐free survival (LRFS) was 52.9%. No case had received pre‐ or postoperative radiotherapy. Univariate analysis revealed that extremity location ( P < .001) and larger size (8 cm or more, P = .036) were significant adverse risk factors for LRFS. Multivariate analysis indicated that extremity location ( P < .001) was a significantly adverse factor in addition to recurrent tumor ( P = .041), S45F mutation ( P = .028), and R1 surgical margin ( P = .039). Preoperative drug treatment, including nonsteroidal antiinflammatory drugs, did not reduce the incidence of local recurrence ( P = .199). This is the first study to analyze the factors correlating with outcomes of surgical treatment, including CTNNB1 mutation status, in a relatively large number of cases from an Asian country. Tumor location was found to be the most influential prognostic factor for local recurrence, similar to the results from Europe and North America. The development of more sensitive method(s) for determination of CTNNB1 mutation is a priority for future study.