Chest wall desmoid tumors

Results of surgical intervention

Abbas E. Abbas, Claude Deschamps, Stephen D. Cassivi, Francis C. Nichols, Mark S. Allen, Cathy D. Schleck, Peter C. Pairolero

Research output: Contribution to journalReview article

86 Citations (Scopus)

Abstract

Background We are analyzing our experience with treatment of desmoid tumors of the chest wall and adjacent structures. Methods A retrospective review was undertaken of the records of all patients who underwent surgical management for a desmoid tumor of the chest between January 1980 and December 2001 at one institution. Fifty-three patients (24 men and 29 women) were identified, whose median age was 39 years (range 10 to 78 years). Results The desmoid tumor involved the chest wall exclusively in 25 patients (47%) and both the chest wall and adjacent structures in 28 (53%). Twenty-eight patients (53%) had previous resections for a desmoid tumor. Three patients also had previous radiation therapy. A wide radical resection was attempted in all 53 patients; resection was complete in 44. Seven patients had positive microscopic margins and 2 had gross residual disease. Complications were noted in 6 patients (11%); no operative deaths occurred. Median hospitalization was 6 days (range 1 to 124 days). Nineteen patients (36%) had postoperative radiation therapy (12 had complete resection and 7 had positive margins). Follow-up was complete in 51 patients (96%) and ranged from 2 weeks to 21 years (median 53 months). At the end of the review 46 patients were alive with no recurrence; 3 were alive with local recurrence and 2 died (1 from metastatic breast cancer and 1 from unknown cause). Five-year overall probability of developing a local recurrence was 37.5% (95% confidence interval, 20.2% to 53.3%). Recurrence occurred in 8 of 9 patients with positive margins (89%) and 8 of 44 with negative margins (18%). Factors adversely affecting the rate of postoperative recurrence were reoperation (p = 0.0199), positive margins (p < 0.0001), and postoperative radiation therapy (p = 0.0027). Eleven patients (22%) required reoperation at a median of 24.6 months postoperatively (range 11 to 78 months). Conclusions Desmoid tumors involving the chest and adjacent structures are locally aggressive tumors with a high recurrence rate. Wide radical resection should be attempted whenever possible. Positive margins at resection, reoperation and postoperative radiation are associated with a high risk of local recurrence.

Original languageEnglish (US)
Pages (from-to)1219-1223
Number of pages5
JournalAnnals of Thoracic Surgery
Volume78
Issue number4
DOIs
StatePublished - Oct 2004

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Aggressive Fibromatosis
Thoracic Wall
Neoplasms
Recurrence
Reoperation
Radiotherapy
Thorax

Keywords

  • 5

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Abbas, A. E., Deschamps, C., Cassivi, S. D., Nichols, F. C., Allen, M. S., Schleck, C. D., & Pairolero, P. C. (2004). Chest wall desmoid tumors: Results of surgical intervention. Annals of Thoracic Surgery, 78(4), 1219-1223. https://doi.org/10.1016/j.athoracsur.2004.03.015

Chest wall desmoid tumors : Results of surgical intervention. / Abbas, Abbas E.; Deschamps, Claude; Cassivi, Stephen D.; Nichols, Francis C.; Allen, Mark S.; Schleck, Cathy D.; Pairolero, Peter C.

In: Annals of Thoracic Surgery, Vol. 78, No. 4, 10.2004, p. 1219-1223.

Research output: Contribution to journalReview article

Abbas, AE, Deschamps, C, Cassivi, SD, Nichols, FC, Allen, MS, Schleck, CD & Pairolero, PC 2004, 'Chest wall desmoid tumors: Results of surgical intervention', Annals of Thoracic Surgery, vol. 78, no. 4, pp. 1219-1223. https://doi.org/10.1016/j.athoracsur.2004.03.015
Abbas AE, Deschamps C, Cassivi SD, Nichols FC, Allen MS, Schleck CD et al. Chest wall desmoid tumors: Results of surgical intervention. Annals of Thoracic Surgery. 2004 Oct;78(4):1219-1223. https://doi.org/10.1016/j.athoracsur.2004.03.015
Abbas, Abbas E. ; Deschamps, Claude ; Cassivi, Stephen D. ; Nichols, Francis C. ; Allen, Mark S. ; Schleck, Cathy D. ; Pairolero, Peter C. / Chest wall desmoid tumors : Results of surgical intervention. In: Annals of Thoracic Surgery. 2004 ; Vol. 78, No. 4. pp. 1219-1223.
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abstract = "Background We are analyzing our experience with treatment of desmoid tumors of the chest wall and adjacent structures. Methods A retrospective review was undertaken of the records of all patients who underwent surgical management for a desmoid tumor of the chest between January 1980 and December 2001 at one institution. Fifty-three patients (24 men and 29 women) were identified, whose median age was 39 years (range 10 to 78 years). Results The desmoid tumor involved the chest wall exclusively in 25 patients (47{\%}) and both the chest wall and adjacent structures in 28 (53{\%}). Twenty-eight patients (53{\%}) had previous resections for a desmoid tumor. Three patients also had previous radiation therapy. A wide radical resection was attempted in all 53 patients; resection was complete in 44. Seven patients had positive microscopic margins and 2 had gross residual disease. Complications were noted in 6 patients (11{\%}); no operative deaths occurred. Median hospitalization was 6 days (range 1 to 124 days). Nineteen patients (36{\%}) had postoperative radiation therapy (12 had complete resection and 7 had positive margins). Follow-up was complete in 51 patients (96{\%}) and ranged from 2 weeks to 21 years (median 53 months). At the end of the review 46 patients were alive with no recurrence; 3 were alive with local recurrence and 2 died (1 from metastatic breast cancer and 1 from unknown cause). Five-year overall probability of developing a local recurrence was 37.5{\%} (95{\%} confidence interval, 20.2{\%} to 53.3{\%}). Recurrence occurred in 8 of 9 patients with positive margins (89{\%}) and 8 of 44 with negative margins (18{\%}). Factors adversely affecting the rate of postoperative recurrence were reoperation (p = 0.0199), positive margins (p < 0.0001), and postoperative radiation therapy (p = 0.0027). Eleven patients (22{\%}) required reoperation at a median of 24.6 months postoperatively (range 11 to 78 months). Conclusions Desmoid tumors involving the chest and adjacent structures are locally aggressive tumors with a high recurrence rate. Wide radical resection should be attempted whenever possible. Positive margins at resection, reoperation and postoperative radiation are associated with a high risk of local recurrence.",
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N2 - Background We are analyzing our experience with treatment of desmoid tumors of the chest wall and adjacent structures. Methods A retrospective review was undertaken of the records of all patients who underwent surgical management for a desmoid tumor of the chest between January 1980 and December 2001 at one institution. Fifty-three patients (24 men and 29 women) were identified, whose median age was 39 years (range 10 to 78 years). Results The desmoid tumor involved the chest wall exclusively in 25 patients (47%) and both the chest wall and adjacent structures in 28 (53%). Twenty-eight patients (53%) had previous resections for a desmoid tumor. Three patients also had previous radiation therapy. A wide radical resection was attempted in all 53 patients; resection was complete in 44. Seven patients had positive microscopic margins and 2 had gross residual disease. Complications were noted in 6 patients (11%); no operative deaths occurred. Median hospitalization was 6 days (range 1 to 124 days). Nineteen patients (36%) had postoperative radiation therapy (12 had complete resection and 7 had positive margins). Follow-up was complete in 51 patients (96%) and ranged from 2 weeks to 21 years (median 53 months). At the end of the review 46 patients were alive with no recurrence; 3 were alive with local recurrence and 2 died (1 from metastatic breast cancer and 1 from unknown cause). Five-year overall probability of developing a local recurrence was 37.5% (95% confidence interval, 20.2% to 53.3%). Recurrence occurred in 8 of 9 patients with positive margins (89%) and 8 of 44 with negative margins (18%). Factors adversely affecting the rate of postoperative recurrence were reoperation (p = 0.0199), positive margins (p < 0.0001), and postoperative radiation therapy (p = 0.0027). Eleven patients (22%) required reoperation at a median of 24.6 months postoperatively (range 11 to 78 months). Conclusions Desmoid tumors involving the chest and adjacent structures are locally aggressive tumors with a high recurrence rate. Wide radical resection should be attempted whenever possible. Positive margins at resection, reoperation and postoperative radiation are associated with a high risk of local recurrence.

AB - Background We are analyzing our experience with treatment of desmoid tumors of the chest wall and adjacent structures. Methods A retrospective review was undertaken of the records of all patients who underwent surgical management for a desmoid tumor of the chest between January 1980 and December 2001 at one institution. Fifty-three patients (24 men and 29 women) were identified, whose median age was 39 years (range 10 to 78 years). Results The desmoid tumor involved the chest wall exclusively in 25 patients (47%) and both the chest wall and adjacent structures in 28 (53%). Twenty-eight patients (53%) had previous resections for a desmoid tumor. Three patients also had previous radiation therapy. A wide radical resection was attempted in all 53 patients; resection was complete in 44. Seven patients had positive microscopic margins and 2 had gross residual disease. Complications were noted in 6 patients (11%); no operative deaths occurred. Median hospitalization was 6 days (range 1 to 124 days). Nineteen patients (36%) had postoperative radiation therapy (12 had complete resection and 7 had positive margins). Follow-up was complete in 51 patients (96%) and ranged from 2 weeks to 21 years (median 53 months). At the end of the review 46 patients were alive with no recurrence; 3 were alive with local recurrence and 2 died (1 from metastatic breast cancer and 1 from unknown cause). Five-year overall probability of developing a local recurrence was 37.5% (95% confidence interval, 20.2% to 53.3%). Recurrence occurred in 8 of 9 patients with positive margins (89%) and 8 of 44 with negative margins (18%). Factors adversely affecting the rate of postoperative recurrence were reoperation (p = 0.0199), positive margins (p < 0.0001), and postoperative radiation therapy (p = 0.0027). Eleven patients (22%) required reoperation at a median of 24.6 months postoperatively (range 11 to 78 months). Conclusions Desmoid tumors involving the chest and adjacent structures are locally aggressive tumors with a high recurrence rate. Wide radical resection should be attempted whenever possible. Positive margins at resection, reoperation and postoperative radiation are associated with a high risk of local recurrence.

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