Surgery>>>>>Soft Tissue Sarcomas
Question 6#

Which of the following is true about desmoid tumors?

A. Local recurrence is observed in up to one-third of patients regardless of microscopic margin of resection status
B. A policy of watchful waiting for desmoids has been validated in prospective clinical trials
C. Analogous to other nonmetastasizing tumors, chemotherapy has no role in the treatment of desmoid tumors
D. Due to their propensity for local invasion, radiotherapy, when used, must be given at a dose of 75 Gy

Correct Answer is A

Comment:

The primary therapy for desmoid tumors has long been considered surgical resection with wide local excision to achieve negative margins. However, local recurrence occurs in up to one-third of patients independently of the quality of surgical margins. Moreover, some authors advocate the possibility to observe patients at presentation, limiting surgery to those who progress or fail medical therapies. Radiation therapy may be effective in patients with unresectable tumors or as adjuvant therapy following surgery for recurrent disease although long-term side effects and the risk of radiation-induced sarcoma should always be considered. When used, a dose of 50 to 54 Gy is usually recommended. Systemic treatment is another option, when surgery is not indicated, although usually reserved for patients with tumor-associated symptoms who have not responded to other interventions. Combinations of methotrexate and vinblastine have been shown to have activity, as have single-agent pegylated liposomal doxorubicin and sorafenib.