title: MRI may be used as a prognostic indicator in patients with extra-abdominal desmoid tumours.
abstract: OBJECTIVE
  To determine the association of MRI features of extra-abdominal desmoid tumours (DTs) with prognosis.
  
  
  METHODS
  MRIs for 90 patients with DT were retrospectively reviewed for imaging features associated with biological behaviour. The primary end point was progression (for lesions managed with chemotherapy, radiation therapy and observation) or recurrence (following surgery). Time to event was studied using univariate and multivariable Cox proportional hazards regression models when accounting for demographic, clinicopathological and imaging variables. Kaplan-Meier plots were used to estimate event-free rate (EFR).
  
  
  RESULTS
  Univariate analysis revealed a significant relationship between EFR and treatment, location and compartment of origin [subcutaneous (SC), superficial fascial, intramuscular (IM) and deep fascial/intermuscular]. None of the imaging features commonly associated with biological behaviour of DTs (e.g., shape, enhancement, T2 signal etc.) or surgical margins (in surgical cases) was associated with EFR. Multivariate analysis showed that treatment modality and compartment of origin were independent predictors of EFR. Superficial and deep fascial lesions had a significantly worse EFR as a group [hazard ratio: 3.9; 95% confidence interval (CI): 1.83-8.32; p = 0.0004] than did the SC and IM lesions as a group. 5-year EFR for the fascial lesions was 18% (95% CI: 6-36%), compared with 57% (95% CI: 25-79%) for the SC and IM groups.
  
  
  CONCLUSIONS
  Intramuscular or SC DTs may be associated with improved prognosis. If validated on multireader and prospective studies, these results can provide for rapid risk stratification at the time of initial MRI.
  
  
  CONCLUSIONS
  This work has shown that imaging features commonly associated with biological activity of desmoid tumours (e.g. shape, T2 signal and enhancement) do not appear to be associated with prognosis in patients undergoing a variety of treatment modalities. The compartment of origin of the lesion, which can be determined on pre-operative MRI, was shown to be associated with prognosis and can allow for risk stratification in patients with DTs.
authors.affiliation: 1 Department of Diagnostic Radiology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.|2 Department of Diagnostic Radiology, University of Texas at Houston, Houston, TX, USA.
authors.forename: Firouzeh
authors.initials: F
authors.lastname: Kamali
authors.affiliation: 3 Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: Wei-Lien
authors.initials: WL
authors.lastname: Wang
authors.affiliation: 4 Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.|5 Departments of Health Services Research, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: B A
authors.initials: BA
authors.lastname: Guadagnolo
authors.affiliation: 6 Departments of Biostatistics, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: Patricia S
authors.initials: PS
authors.lastname: Fox
authors.affiliation: 7 Departments of Orthopedic Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: Valerae O
authors.initials: VO
authors.lastname: Lewis
authors.affiliation: 3 Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Lazar
authors.affiliation: 8 Departments of Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Conley
authors.affiliation: 8 Departments of Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: Vinod
authors.initials: V
authors.lastname: Ravi
authors.affiliation: 9 Department of Diagnostic Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Toliyat
authors.affiliation: 1 Department of Diagnostic Radiology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: Harshad S
authors.initials: HS
authors.lastname: Ladha
authors.affiliation: 5 Departments of Health Services Research, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: Brian P
authors.initials: BP
authors.lastname: Hobbs
authors.affiliation: 1 Department of Diagnostic Radiology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: Behrang
authors.identifier: http://orcid.org/0000-0002-4962-3466
authors.initials: B
authors.lastname: Amini
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D018222:Desmoid Tumors / Q000473:pathology* / Q000628:therapy; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies