title: Incidence and treatment of recurrent plantar fibromatosis by surgery and postoperative radiotherapy.
abstract: BACKGROUND
  The incidence of plantar fibromatosis (PF) is unknown. Sometimes PF tends to recur repetitively after surgical treatment. In our institute we have used postoperative radiotherapy in an attempt to diminish the change on recurrence.
  
  
  METHODS
  The Dutch Network and National Database for Pathology (PALGA) was consulted to establish the incidence of plantar fibromatosis (PF). Data from 9 patients (11 feet) with PF referred to our institute for recurrent disease were analyzed and the role of postoperative radiotherapy in prevention of recurrence was studied.
  
  
  RESULTS
  An average of 1.2 operations for PF was performed per 100,000 citizens yearly in the Netherlands. Twenty-six operations were performed and postoperative radiotherapy was used in 6 cases. Plantar fasciectomy was associated with the lowest recurrence rate. After microscopically incomplete excision or excision of early recurrence (< or =6 months) alone all tumors recurred, while recurrence was rarely observed after adjuvant radiotherapy. However, radiotherapy was associated with significantly impaired functional outcome in 3 cases.
  
  
  CONCLUSIONS
  Plantar fibromatosis is relatively rare. Plantar fasciectomy seems to be the operation of choice. Although effective in decreasing the recurrence rate, adjuvant radiotherapy should be used very selectively because of its serious side effects.
authors.affiliation: Department of Surgical Oncology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Huis, Plesmanlaan 121, 1066 CX Amsterdam, Netherlands.
authors.forename: Eelco
authors.initials: E
authors.lastname: de Bree
authors.forename: Frans A N
authors.initials: FA
authors.lastname: Zoetmulder
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Keus
authors.forename: Hans L
authors.initials: HL
authors.lastname: Peterse
authors.forename: Frits
authors.initials: F
authors.lastname: van Coevorden
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D005350:Fibroma / Q000453:epidemiology / Q000532:radiotherapy* / Q000601:surgery*; D005534:Foot Diseases / Q000453:epidemiology / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000532:radiotherapy* / Q000601:surgery*; D011182:Postoperative Care; D012307:Risk Factors