title: A critical analysis of treatment strategies in desmoid tumours: a review of a series of 106 cases.
abstract: BACKGROUND
  The management of desmoid tumours, previously based on strategies employed for sarcomas, should be reassessed, given the morbidity of interventions used in their treatment.
  
  
  METHODS
  Long-term follow-up (median 123 months) of a series of 106 treated patients with 69 primary and 37 recurrent desmoids, in order to study natural history and outcome.
  
  
  RESULTS
  Desmoids typically evolved actively over a median period of 3 years, and stabilised thereafter. Recurrences or progression most commonly occurred between 14 and 17 months. Risk factors for recurrence were presentation (primary vs. recurrent), gender, tumour location and resection margins. However, survival was independent from these factors, with equivalent survival whether resection had been performed or not. Tumour control and functional outcome depended on location and presentation. Functional impairment was proportional to number of operations and whether patients had received radiotherapy. Recurrences were observed in 12/23 patients after radiotherapy.
  
  
  CONCLUSIONS
  Desmoids are relatively indolent tumours needing different approaches than sarcomas. Direct surgery is advisable only in primary lower trunk wall/girdle locations. Wait-and-see and medical treatment is preferable in other types of presentations.
authors.affiliation: Department of Surgery, Institut Bergonié, Regional Cancer Centre, Bordeaux Cedex, France. stoeckle@bergonie.org
authors.forename: E
authors.initials: E
authors.lastname: Stoeckle
authors.forename: J M
authors.initials: JM
authors.lastname: Coindre
authors.forename: M
authors.initials: M
authors.lastname: Longy
authors.forename: M Bui Nguyen
authors.initials: MB
authors.lastname: Binh
authors.forename: G
authors.initials: G
authors.lastname: Kantor
authors.forename: M
authors.initials: M
authors.lastname: Kind
authors.forename: C Tunon
authors.initials: CT
authors.lastname: de Lara
authors.forename: A
authors.initials: A
authors.lastname: Avril
authors.forename: F
authors.initials: F
authors.lastname: Bonichon
authors.forename: B Nguyen
authors.initials: BN
authors.lastname: Bui