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Article Open Access

Effect of surgical margins on prognosis in aggressive fibromatosis: A single‑institutional analysis of 90 patients

  • Authors:
    • Kamran Harati
    • Anais Jaenisch
    • Björn Behr
    • Ole Goertz
    • Ali Harati
    • Tobias Hirsch
    • Ingo Stricker
    • Marcus Lehnhardt
    • Adrien Daigeler
  • View Affiliations / Copyright

    Affiliations: Department of Plastic Surgery, BG‑University Hospital Bergmannsheil, D‑44789 Bochum, Germany, Department of Neurosurgery, Klinikum Dortmund, D‑44145 Dortmund, Germany, Institute of Pathology, Ruhr‑University Bochum, D‑44789 Bochum, Germany
    Copyright: © Harati et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 5129-5134
    |
    Published online on: September 1, 2017
       https://doi.org/10.3892/ol.2017.6864
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Abstract

The treatment of aggressive fibromatosis poses a therapeutic challenge in an interdisciplinary setting. The extent of surgical resection is still discussed controversially. The present retrospective analysis aimed to determine prognostic factors leading to recurrence. Between 2000 and 2014, 114 patients with aggressive fibromatosis were treated surgically at BG‑University Hospital Bergmannsheil (Bochum, Germany). Univariate and multivariate analyses were restricted to 90 participants with information available on surgical margins at the initial procedure. The median follow‑up time was 7.7 years. A total of 45 patients (50%) developed recurrence during follow‑up. Primary tumors were resected with negative margins (R0) in 50 patients (68%) and with microscopically positive margins (R1) in 28 patients (25%). In addition, tumors in 12 patients (7%) were resected with macroscopically positive margins at the initial surgical procedure. The rates of recurrence‑free survival (RFS) after 5 years were 68.8% [95% confidence interval (CI), 53.5‑79.9%] in patients with R0‑resected primary tumors and 34.1% (95% CI, 19.9‑48.9%) in patients with R1/R2‑status (P=0.001). Narrow and wide clear margins within the R0‑group were not associated with significantly different outcomes. Adjuvant radiation, tumor site and patient age were not associated with a significant alteration of RFS. The current results suggest that the attainment of microscopically negative surgical margins at the initial surgical treatment is associated with a significantly improved prognosis. A conservative surgical approach involving the attainment of narrow negative margins while preserving function should be sought in patients in whom tumor resection is indicated. The decision for resection should be made interdisciplinary in each case based on tumor progression, available treatment alternatives and the decision of the informed patient.
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Copy and paste a formatted citation
Spandidos Publications style
Harati K, Jaenisch A, Behr B, Goertz O, Harati A, Hirsch T, Stricker I, Lehnhardt M and Daigeler A: Effect of surgical margins on prognosis in aggressive fibromatosis: A single‑institutional analysis of 90 patients. Oncol Lett 14: 5129-5134, 2017.
APA
Harati, K., Jaenisch, A., Behr, B., Goertz, O., Harati, A., Hirsch, T. ... Daigeler, A. (2017). Effect of surgical margins on prognosis in aggressive fibromatosis: A single‑institutional analysis of 90 patients. Oncology Letters, 14, 5129-5134. https://doi.org/10.3892/ol.2017.6864
MLA
Harati, K., Jaenisch, A., Behr, B., Goertz, O., Harati, A., Hirsch, T., Stricker, I., Lehnhardt, M., Daigeler, A."Effect of surgical margins on prognosis in aggressive fibromatosis: A single‑institutional analysis of 90 patients". Oncology Letters 14.5 (2017): 5129-5134.
Chicago
Harati, K., Jaenisch, A., Behr, B., Goertz, O., Harati, A., Hirsch, T., Stricker, I., Lehnhardt, M., Daigeler, A."Effect of surgical margins on prognosis in aggressive fibromatosis: A single‑institutional analysis of 90 patients". Oncology Letters 14, no. 5 (2017): 5129-5134. https://doi.org/10.3892/ol.2017.6864
Copy and paste a formatted citation
x
Spandidos Publications style
Harati K, Jaenisch A, Behr B, Goertz O, Harati A, Hirsch T, Stricker I, Lehnhardt M and Daigeler A: Effect of surgical margins on prognosis in aggressive fibromatosis: A single‑institutional analysis of 90 patients. Oncol Lett 14: 5129-5134, 2017.
APA
Harati, K., Jaenisch, A., Behr, B., Goertz, O., Harati, A., Hirsch, T. ... Daigeler, A. (2017). Effect of surgical margins on prognosis in aggressive fibromatosis: A single‑institutional analysis of 90 patients. Oncology Letters, 14, 5129-5134. https://doi.org/10.3892/ol.2017.6864
MLA
Harati, K., Jaenisch, A., Behr, B., Goertz, O., Harati, A., Hirsch, T., Stricker, I., Lehnhardt, M., Daigeler, A."Effect of surgical margins on prognosis in aggressive fibromatosis: A single‑institutional analysis of 90 patients". Oncology Letters 14.5 (2017): 5129-5134.
Chicago
Harati, K., Jaenisch, A., Behr, B., Goertz, O., Harati, A., Hirsch, T., Stricker, I., Lehnhardt, M., Daigeler, A."Effect of surgical margins on prognosis in aggressive fibromatosis: A single‑institutional analysis of 90 patients". Oncology Letters 14, no. 5 (2017): 5129-5134. https://doi.org/10.3892/ol.2017.6864
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