Desmoid Fibroma: are We Ready to Avoid the Surgical Treatment?

Thirty years experience of treatment of soft tissue desmoid fibroma (Moscow Oncologic Institute) is presented. Efficacy of surgical treatment versus combined and radiation therapy was studied. The rate of relapse of extraabdominal desmoids after surgical treatment was 94%, after combined treatment with preoperative radiation therapy the relapse rate decreased up to 27.5% but after postoperative radiation therapy up to 53%. After radiation therapy the relapse rate was 15.7%. However radiation therapy has limitations related the necessity of massive tumor irradiation and application of high doses of irradiation that may cause postradiation affect of tissues. During subsequent search the original method of chemiotherapy (tamoxiphen, vinblastin, methotrecoat) was tested. This method allows to achieve the persistent remission in 81.3% of patients. Principles of therapeutic tactics in desmoid fibromas are formulated.