Item request has been placed! ×
Item request cannot be made. ×
loading  Processing Request

Evolving Practice Patterns Over Two Decades (1993–2013) in the Management of Desmoid-type Fibromatosis in British Columbia

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
  • Additional Information
    • Affiliation:
      Faculty of Medicine, Island Medical Program, University of British Columbia, Victoria, British Columbia, Canada
      Department of Mathematics and Statistics, University of Calgary, Calgary, Alberta, Canada
      Department of Surgery, Vancouver General Hospital, University of British Columbia, British Columbia Cancer Agency – Vancouver Center, Vancouver, British Columbia, Canada
      § Department of Medical Oncology, University of British Columbia, British Columbia Cancer Agency – Vancouver Center, Vancouver, British Columbia, Canada
      Department of Radiation Oncology, University of British Columbia, British Columbia Cancer Agency – Vancouver Center, Vancouver, British Columbia, Canada
      || Department of Medical Imaging, Vancouver General Hospital, University of British Columbia, British Columbia Cancer Agency – Vancouver Center, Vancouver, British Columbia, Canada
    • Note:
      Presented in part at the Toronto International Sarcoma Symposium, 6–7 June 2018.
    • Keywords:
      Active surveillance
      chemotherapy
      desmoid-type fibromatosis
      radiation therapy
      surgery
      tamoxifen
    • Abstract:
      Aims Due to the rarity and varied natural history of desmoid-type fibromatosis, evidence-based treatment standards for this disease remain lacking. This study evaluated outcomes in patients with desmoid-type fibromatosis managed at a Canadian institution over two decades.
    • Abstract:
      Results Thirty-two per cent of cases were men, median age 40 years, median tumour size 5.4 cm. Initial treatments were surgery (79%), tamoxifen (13%), radiation therapy (5.0%), chemotherapy (1.8%) and cryoablation (1.2%). Active surveillance was used upfront in 26% of cases, most after 2005. At a median follow-up of 77 months, one patient died of disease, 13 died of unrelated causes and the remainder were alive with no evidence of disease (56%), stable/responding disease (33%) or progressive disease (4%). The recurrence rate was 25% after upfront surgery. Response rates and disease control rates were 40% and 76% for active surveillance; 68% and 96% for radiation therapy; 31% and 67% for tamoxifen; and 53% and 80% for chemotherapy. On univariable analysis, factors associated with a higher recurrence after initial surgery were young age (P = 0.012), male gender (P = 0.012) and extremity location (P = 0.005). On multivariable analysis, only young age was significantly associated with recurrence risk (P = 0.010).
    • Abstract:
      Conclusions Active surveillance was associated with spontaneous regression and long-term disease control consistent with other studies. Primary radiation therapy appeared to provide a similar response and disease control compared with systemic treatments and may be a viable option for patients who are not candidates for surgery or active surveillance.
    • Abstract:
      @@@@Highlights •Multidisciplinary outcome data from a large series at a Canadian institution.•Active surveillance was associated with spontaneous regression and long-term disease control.•Practice shift from upfront surgery to active surveillance was observed after 2005.•Primary radiation treatment was at least as effective as systemic treatments.•Radiation therapy is a viable option when active surveillance fails or when surgery is not recommended.
    • ISSN:
      0936-6555
    • Accession Number:
      10.1016/j.clon.2019.10.005
    • Accession Number:
      S0936655519304522
    • Copyright:
      © 2019 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
  • Citations
    • ABNT:
      DE BRUYNS, A. et al. Evolving Practice Patterns Over Two Decades (1993–2013) in the Management of Desmoid-type Fibromatosis in British Columbia. Clinical Oncology, [s. l.], v. 32, n. 4, p. e102–e110, 2020. DOI 10.1016/j.clon.2019.10.005. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edselp&AN=S0936655519304522. Acesso em: 21 set. 2020.
    • AMA:
      de Bruyns A, Li H, MacNeil A, et al. Evolving Practice Patterns Over Two Decades (1993–2013) in the Management of Desmoid-type Fibromatosis in British Columbia. Clinical Oncology. 2020;32(4):e102-e110. doi:10.1016/j.clon.2019.10.005
    • APA:
      de Bruyns, A., Li, H., MacNeil, A., Simmons, C., Clarkson, P., Goddard, K., Munk, P. L., Hart, J. J., Holloway, C., Truong, P., & Feng, X. (2020). Evolving Practice Patterns Over Two Decades (1993–2013) in the Management of Desmoid-type Fibromatosis in British Columbia. Clinical Oncology, 32(4), e102–e110. https://doi.org/10.1016/j.clon.2019.10.005
    • Chicago/Turabian: Author-Date:
      de Bruyns, A., H. Li, A. MacNeil, C. Simmons, P. Clarkson, K. Goddard, P.L. Munk, et al. 2020. “Evolving Practice Patterns Over Two Decades (1993–2013) in the Management of Desmoid-Type Fibromatosis in British Columbia.” Clinical Oncology 32 (4): e102–10. doi:10.1016/j.clon.2019.10.005.
    • Harvard:
      de Bruyns, A. et al. (2020) ‘Evolving Practice Patterns Over Two Decades (1993–2013) in the Management of Desmoid-type Fibromatosis in British Columbia’, Clinical Oncology, 32(4), pp. e102–e110. doi: 10.1016/j.clon.2019.10.005.
    • Harvard: Australian:
      de Bruyns, A, Li, H, MacNeil, A, Simmons, C, Clarkson, P, Goddard, K, Munk, PL, Hart, JJ, Holloway, C, Truong, P & Feng, X 2020, ‘Evolving Practice Patterns Over Two Decades (1993–2013) in the Management of Desmoid-type Fibromatosis in British Columbia’, Clinical Oncology, vol. 32, no. 4, pp. e102–e110, viewed 21 September 2020, .
    • MLA:
      de Bruyns, A., et al. “Evolving Practice Patterns Over Two Decades (1993–2013) in the Management of Desmoid-Type Fibromatosis in British Columbia.” Clinical Oncology, vol. 32, no. 4, Apr. 2020, pp. e102–e110. EBSCOhost, doi:10.1016/j.clon.2019.10.005.
    • Chicago/Turabian: Humanities:
      de Bruyns, A., H. Li, A. MacNeil, C. Simmons, P. Clarkson, K. Goddard, P.L. Munk, et al. “Evolving Practice Patterns Over Two Decades (1993–2013) in the Management of Desmoid-Type Fibromatosis in British Columbia.” Clinical Oncology 32, no. 4 (April 1, 2020): e102–10. doi:10.1016/j.clon.2019.10.005.
    • Vancouver/ICMJE:
      de Bruyns A, Li H, MacNeil A, Simmons C, Clarkson P, Goddard K, et al. Evolving Practice Patterns Over Two Decades (1993–2013) in the Management of Desmoid-type Fibromatosis in British Columbia. Clinical Oncology [Internet]. 2020 Apr 1 [cited 2020 Sep 21];32(4):e102–10. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edselp&AN=S0936655519304522