Margins in extra-abdominal desmoid tumors: a comparative analysis.
OBJECTIVE
The main treatment of extra-abdominal desmoid tumors remains surgery, but recurrence rates up to 80% are reported. The impact of microscopic surgical margin status according to the Enneking classification system is discussed controversially.


METHODS
Therefore, the authors screened the published literature for reliable data on the importance of a wide or radical excision of extra-abdominal desmoid tumors. All studies with more than ten patients, a surgical treatment only, and margin status stated were included.


RESULTS
Only 12 out of 49 identified studies fulfilled the inclusion criteria. One hundred fifty-two primary tumors were excised with wide or radical microscopic surgical margins, while in 260 cases a marginal or intralesional excision was performed. In the first group 41 patients (27%) and in the second one 187 patients (72%) developed a recurrence. Therefore, microscopic surgical margin status according to the Enneking classification system is a significant prognostic factor (P < 0.001).


CONCLUSIONS
The data of this review underline the strategy of a wide or radical local excision as the treatment of choice. Furthermore, as a large number of studies had to be excluded from this analysis, exact microscopic surgical margin status should be provided in future studies in order to allow comparability. .
Leithner
Andreas
A
Department of Orthopedic Surgery, Medical University Graz, Graz, Austria.
Gapp
Markus
M
Leithner
Katharina
K
Radl
Roman
R
Krippl
Peter
P
Beham
Alfred
A
Windhager
Reinhard
R
D016009:Chi-Square Distribution; D003627:Data Interpretation, Statistical; D018222:Desmoid Tumors / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000209:etiology*; D012983:Soft Tissue Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*