PMID- 36010900 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230308 IS - 2072-6694 (Print) IS - 2072-6694 (Electronic) IS - 2072-6694 (Linking) VI - 14 IP - 16 DP - 2022 Aug 12 TI - Management of Patients with Newly Diagnosed Desmoid Tumors in a First-Line Setting. LID - 10.3390/cancers14163907 [doi] LID - 3907 AB - The initial management of desmoid tumors (DTs) is shifting from surgery towards active surveillance, with systemic and locally ablative treatments reserved for enlarging and/or symptomatic disease. However, it remains unclear which patients would benefit most from an initial conservative rather than interventional approach. To answer this question, we retrospectively analyzed adult and pediatric patients with DTs treated at a tertiary academic cancer center between 1992 and 2022. Outcomes measured were progression-free survival (PFS) and time to next treatment (TTNT) after first-line therapy. A total of 262 treatment-naive patients were eligible for analysis with a median age of 36.5 years (range, 0-87 years). The 5-year PFS and the median TTNT (months) after first-line treatment were, respectively: 50.6% and 69.1 mo for surgery; 64.9% and 149.5 mo for surgery plus adjuvant radiotherapy; 57.1% and 44.7 mo for surgery plus adjuvant systemic therapy; 24.9% and 4.4 mo for chemotherapy; 26.7% and 5.3 mo for hormonal therapy; 41.3% and 29.6 mo for tyrosine kinase inhibitors (TKIs); 44.4% and 8.9 mo for cryoablation and high intensity focused ultrasound; and 43.1% and 32.7 mo for active surveillance. Age 60 mm (p = 0.04), and hormonal therapy (p = 0.03) predicted a higher risk of progression. Overall, our results suggest that active surveillance should be considered initially for patients with smaller asymptomatic DTs, while upfront TKIs, local ablation, and surgery achieve similar outcomes in those with more aggressive disease. FAU - Testa, Stefano AU - Testa S AUID- ORCID: 0000-0001-5632-5021 AD - Department of Medicine, Stanford University, Stanford, CA 94304, USA. FAU - Bui, Nam Q AU - Bui NQ AD - Division of Oncology, Department of Medicine, Stanford University, Stanford, CA 94304, USA. FAU - Charville, Gregory W AU - Charville GW AUID- ORCID: 0000-0002-2774-2704 AD - Department of Pathology, Stanford University, Stanford, CA 94304, USA. FAU - Avedian, Raffi S AU - Avedian RS AD - Department of Orthopedic Surgery, Stanford University, Redwood City, CA 94063, USA. FAU - Steffner, Robert AU - Steffner R AD - Department of Orthopedic Surgery, Stanford University, Redwood City, CA 94063, USA. FAU - Ghanouni, Pejman AU - Ghanouni P AD - Department of Radiology, Stanford University, Stanford, CA 94304, USA. FAU - Mohler, David G AU - Mohler DG AD - Department of Orthopedic Surgery, Stanford University, Redwood City, CA 94063, USA. FAU - Ganjoo, Kristen N AU - Ganjoo KN AD - Division of Oncology, Department of Medicine, Stanford University, Stanford, CA 94304, USA. LA - eng PT - Journal Article DEP - 20220812 PL - Switzerland TA - Cancers (Basel) JT - Cancers JID - 101526829 PMC - PMC9405618 OTO - NOTNLM OT - active surveillance OT - chemotherapy OT - cryoablation OT - desmoid tumor OT - high intensity focused ultrasound OT - hormonal therapy OT - surgery OT - tyrosine kinase inhibitors COIS- The authors declare no conflict of interest. EDAT- 2022/08/27 06:00 MHDA- 2022/08/27 06:01 PMCR- 2022/08/12 CRDT- 2022/08/26 01:13 PHST- 2022/07/20 00:00 [received] PHST- 2022/08/09 00:00 [revised] PHST- 2022/08/11 00:00 [accepted] PHST- 2022/08/26 01:13 [entrez] PHST- 2022/08/27 06:00 [pubmed] PHST- 2022/08/27 06:01 [medline] PHST- 2022/08/12 00:00 [pmc-release] AID - cancers14163907 [pii] AID - cancers-14-03907 [pii] AID - 10.3390/cancers14163907 [doi] PST - epublish SO - Cancers (Basel). 2022 Aug 12;14(16):3907. doi: 10.3390/cancers14163907.