Treatment results of unresected or partially resected desmoid tumors

The authors compare the progression-free survival of patients with unresect ed or partially resected desmoid tumors treated with radiotherapy with thos e not given radiotherapy. A retrospective analysis and pathologic review wa s performed on 14 patients treated at the University of California Los Ange les School of Medicine from 1965 through 1992. Median follow-up was 6 years . The 6-year progression-free survival for irradiated patients was 100%, co mpared with 50% for those not irradiated (p = 0.04). Of the seven patients irradiated, only two had a complete response and one had a partial response . There was no difference in disease-specific survival between patients irr adiated and those not irradiated, because only 1 of 14 patients died of des moid tumor progression, which caused airway obstruction. This data suggest that radiotherapy may improve the progression-free survival of patients wit h unresected or partially resected desmoid tumor; however, the number of pa tients in this series is small. Most patients did not have a complete respo nse to radiotherapy. For patients with tumor adjacent to the airway in the neck or upper thorax, the authors recommend radiotherapy because of the pot ential for mortality. Otherwise, because tumor progression rarely causes de ath, one must consider whether the morbidity of treatment would outweigh th e morbidity of disease progression.