title: Treatment and follow-up strategies in desmoid tumours: a practice guideline.
abstract: OBJECTIVE
  We set out to determine the optimal treatment options-surgery, radiation therapy (rt), systemic therapy, or any combinations thereof-for patients with desmoid tumours once the decision to undergo active treatment has been made (that is, monitoring and observation have been determined to be inadequate).provide clinical-expert consensus opinions on follow-up strategies in patients with desmoid tumours after primary interventional management.
  
  
  METHODS
  This guideline was developed by Cancer Care Ontario's Program in Evidence-Based Care and the Sarcoma Disease Site Group. The medline, embase, and Cochrane Library databases, main guideline Web sites, and abstracts of relevant annual meetings (1990 to September 2012) were searched. Internal and external reviews were conducted, with final approval by the Program in Evidence-Based Care and the Sarcoma Disease Site Group.
  Surgery with or without rt can be a reasonable treatment option for patients with desmoid tumours whose surgical morbidity is deemed to be low.The decision about whether rt should be offered in conjunction with surgery should be made by clinicians and patients after weighing the potential benefit of improved local control against the potential harms and toxicity associated with rt.Depending on individual patient preferences, systemic therapy alone or rt alone might also be reasonable treatment options, regardless of whether the desmoid umours are deemed to be resectable.
  Undergo evaluation for rehabilitation (occupational therapy or physical therapy, or both).Continue with rehabilitation until maximal function is achieved.Undergo history and physical examinations with appropriate imaging every 3-6 months for 2-3 years, and then annually.
authors.affiliation: Division of Orthopaedic Surgery, Juravinski Cancer Centre, Hamilton, ON.
authors.forename: M
authors.initials: M
authors.lastname: Ghert
authors.affiliation: Cancer Care Ontario's Program in Evidence-Based Care, Department of Oncology, McMaster University, Hamilton, ON.
authors.forename: X
authors.initials: X
authors.lastname: Yao
authors.affiliation: Department of Radiation Oncology, Juravinski Cancer Centre, Hamilton, ON.
authors.forename: T
authors.initials: T
authors.lastname: Corbett
authors.affiliation: Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON.
authors.forename: A A
authors.initials: AA
authors.lastname: Gupta
authors.affiliation: Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON.
authors.forename: R A
authors.initials: RA
authors.lastname: Kandel
authors.affiliation: Department of Medical Oncology, The Ottawa Hospital Regional Cancer Centre, Ottawa, ON.
authors.forename: S
authors.initials: S
authors.lastname: Verma
authors.affiliation: Department of Orthopaedic Surgery, The Ottawa Hospital Regional Cancer Centre, Ottawa, ON.
authors.forename: J
authors.initials: J
authors.lastname: Werier
keywords: Clinical practice guideline; desmoid tumours; follow-up; treatment
references.citation: J Clin Oncol. 1995 Nov;13(11):2813-8
references.pmid: 7595743
references.citation: Ann Oncol. 2012 Jan;23(1):182-186
references.pmid: 21444357
references.citation: Int J Radiat Oncol Biol Phys. 1990 Jul;19(1):37-40
references.pmid: 2380093
references.citation: Int J Radiat Oncol Biol Phys. 1990 Mar;18(3):535-40
references.pmid: 2318685
references.citation: J Surg Oncol. 2000 Aug;74(4):291-6
references.pmid: 10962463
references.citation: Int J Radiat Oncol Biol Phys. 2008 Jun 1;71(2):441-7
references.pmid: 18068311
references.citation: Br J Cancer. 2011 Jan 4;104(1):37-42
references.pmid: 21063417
references.citation: Eur J Surg Oncol. 2004 May;30(4):428-32
references.pmid: 15063897
references.citation: J Thorac Cardiovasc Surg. 1992 Oct;104(4):900-3
references.pmid: 1405687
references.citation: Br J Surg. 1995 Apr;82(4):510-4
references.pmid: 7613897
references.citation: Histol Histopathol. 2012 May;27(5):641-9
references.pmid: 22419028
references.citation: Eur J Surg Oncol. 2010 Jan;36(1):84-8
references.pmid: 19682833
references.citation: Pediatr Blood Cancer. 2011 Sep;57(3):435-42
references.pmid: 21744472
references.citation: Int Orthop. 2004 Aug;28(4):252-6
references.pmid: 15168085
references.citation: J Bone Joint Surg Am. 1996 Jun;78(6):848-54
references.pmid: 8666602
references.citation: Int J Radiat Oncol Biol Phys. 2001 May 1;50(1):121-5
references.pmid: 11316554
references.citation: Curr Oncol. 2014 Aug;21(4):e613-29
references.pmid: 25089111
references.citation: Cancer. 2010 May 1;116(9):2258-65
references.pmid: 20187095
references.citation: Cancers (Basel). 2012 Feb 07;4(1):88-99
references.pmid: 24213228
references.citation: Ann Thorac Surg. 2004 Oct;78(4):1219-23; discussion 1219-23
references.pmid: 15464474
references.citation: Ann Oncol. 2011 Feb;22(2):452-7
references.pmid: 20622000
references.citation: Int J Radiat Oncol Biol Phys. 1993 Aug 1;26(5):851-8
references.pmid: 8344854
references.citation: S Afr J Surg. 2006 Feb;44(1):6-8, 10-1
references.pmid: 16619984
references.citation: Int J Radiat Oncol Biol Phys. 1998 Dec 1;42(5):1007-14
references.pmid: 9869223
references.citation: Cancer. 2001 Sep 1;92(5):1259-64
references.pmid: 11571741
references.citation: Int J Radiat Oncol Biol Phys. 2011 Jul 1;80(3):787-92
references.pmid: 20615622
references.citation: Eur J Surg Oncol. 2008 Apr;34(4):462-8
references.pmid: 17709227
references.citation: Eur J Surg Oncol. 2012 Aug;38(8):700-5
references.pmid: 22464107
references.citation: Int J Radiat Oncol Biol Phys. 1998 Feb 1;40(3):637-45
references.pmid: 9486614
references.citation: Sarcoma. 2012;2012:475202
references.pmid: 22924016
references.citation: Radiother Oncol. 1995 Jan;34(1):17-22
references.pmid: 7792394
references.citation: Radiat Oncol. 2007 Mar 07;2:12
references.pmid: 17343751
references.citation: J Surg Oncol. 2009 Dec 1;100(7):563-9
references.pmid: 19722232
references.citation: Int J Radiat Oncol Biol Phys. 2010 Mar 15;76(4):1154-60
references.pmid: 19647952
references.citation: Eur J Cancer. 2008 Nov;44(16):2404-10
references.pmid: 18706807
references.citation: J Clin Oncol. 1995 Feb;13(2):502-12
references.pmid: 7844612
references.citation: Acta Oncol. 2011 Apr;50(3):455-61
references.pmid: 20799916
references.citation: Eur J Surg Oncol. 2009 Feb;35(2):129-34
references.pmid: 18760561
references.citation: Int J Radiat Oncol Biol Phys. 1997 Oct 1;39(3):659-65
references.pmid: 9336146
references.citation: Cancer. 2010 Jan 1;116(1):233-40
references.pmid: 19950127
references.citation: Cancer. 2000 Apr 1;88(7):1517-23
references.pmid: 10738207
references.citation: Cancer. 1999 Nov 15;86(10):2045-52
references.pmid: 10570430
references.citation: J Surg Oncol. 2010 Oct 1;102(5):380-4
references.pmid: 19877160
references.citation: Int J Oncol. 1995 Oct;7(4):773-6
references.pmid: 21552902
references.citation: Dis Colon Rectum. 2000 Mar;43(3):363-9
references.pmid: 10733118
references.citation: Int Orthop. 2005 Aug;29(4):210-3
references.pmid: 15900438
references.citation: J Clin Oncol. 1999 Jan;17(1):158-67
references.pmid: 10458229
references.citation: Acta Orthop Scand. 2002 Apr;73(2):213-9
references.pmid: 12079022
references.citation: Clin Orthop Relat Res. 2000 Jun;(375):207-13
references.pmid: 10853171
references.citation: Rare Tumors. 2013 Feb 11;5(1):e2
references.pmid: 23772301
references.citation: Clin Orthop Relat Res. 2003 Oct;(415):19-24
references.pmid: 14612625
references.citation: Clin Cancer Res. 2010 Oct 1;16(19):4884-91
references.pmid: 20724445