title: Surgical treatment for local control of extremity and trunk desmoid tumors.
abstract: BACKGROUND
  Surgical treatment has been the mainstay for extremity and trunk desmoid tumors with a negative surgical margin. However, even when resection with a wide surgical margin is achieved, the local recurrence rate remains high. The purpose of this study was to analyze the clinical outcome of patients with extremity and trunk desmoid tumors after surgical treatment and to determine the factors influencing local recurrence.
  
  
  METHODS
  Between January 1991 and December 2003, 30 of 58 patients with desmoid tumors referred to our institutions and surgically treated and followed up for more than 2 years were selected for this study. Patient age, gender, tumor size, location, status of disease (primary or recurrent), and surgical margins were analyzed as possible risk factors for recurrence.
  
  
  RESULTS
  Sixteen (53%) of the 30 patients had a local recurrence. Eight of the 19 patients (42.1%) with a negative surgical margin experienced a recurrence. Younger age (<30 years) was a significant risk factor for local recurrence (P < 0.05). Tumor size, surgical margin and previous surgical history were not associated with local recurrence. Younger age and female gender had a propensity for local recurrence, suggesting that the biological behavior of desmoid tumor may depend on the status of the disease at presentation.
  
  
  CONCLUSIONS
  These results suggest that radical surgical treatment causing severe functional impairment should be avoided in selected cases on the basis of patient characteristics, and that other novel therapeutic tools may be necessary for patients in whom a higher risk of local recurrence is assumed or severe complications after surgical treatment are predicted.
authors.affiliation: Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
authors.forename: Yoji
authors.initials: Y
authors.lastname: Shido
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nishida
authors.forename: Hiroatsu
authors.initials: H
authors.lastname: Nakashima
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Katagiri
authors.forename: Hideshi
authors.initials: H
authors.lastname: Sugiura
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Yamada
authors.forename: Naoki
authors.initials: N
authors.lastname: Ishiguro
mesh_terms: D000005:Abdomen; D000293:Adolescent; D000328:Adult; D000368:Aged; D001132:Arm; D002648:Child; D005260:Female; D018222:Desmoid Tumors / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013909:Thorax; D055815:Young Adult