Clinical Analysis Of 140 Cases Of Non-abdominal Desmoid Fibromatosis

Background and ObjectiveAggressive fibromatosis(AF)is a rare neoplasm originating from muscle or the junction between muscle and fascia.It is reported that the incidence of this disease is about 5～6 people per 1 million of the population per annum over the globe.The histological manifestations of AF are benign and there is no distant metastasis,but it is characterized by the ability of local infiltration and high postoperative local recurrence.The aim of this study was to explore the epidemiological characteristics of AF and the potential factors that may affect the prognosis of patients so as to provide clinical diagnosis and treatment experience and offer a theoretical reference for prognosis optimization.MethodsAll statistical data was processed by statistical software IBM SPSS Statistics 21.0.1.Retrospective analysis was performed on 140 patients with AF who underwent surgical resection in the First Affiliated Hospital of Zhengzhou University from May 2012 to November 2020.The clinical characteristics of the patients,including gender,age,involved region,maximum linear dimension,multiple tumors,initial or recurrent disease,history of trauma,β-catenin,CTNNB1 gene mutation,postoperative adjuvant radiotherapy,and recurrence,were statistically described.2.Survival rates of age,gender,involved region,recurrence,initial or recurrent disease,history of trauma and postoperative adjuvant radiotherapy were estimated according to Kaplan-Meier method respectively,and were compared using the log-rank test.Multivariate analysis was performed using the Cox proportional hazards regression model,variables that were assiciated with P<0.10 in the univariate analysis were included in the Cox proportional hazards regression model to assess independent prognostic factors for RFS.P<0.05 was considered to indicate a statistically significant result.Results1.There were no statistically significant differences in gender,age,maximum linear dimension,multiple tumors,history of trauma and postoperative adjuvant radiotherapy between the recurrence group and the non-recurrence group(P>0.05).There were statistically significant differences in tumor site(P=0.027)and initial or recurrent disease(P=0.012)between the recurrence group and the non-recurrence group.Stratified analysis of the specific site of tumor showed that postoperative RFS was higher in patients with abdominal wall lesions than in other sites(P=0.018),and lower in patients with extremities lesions than in other sites(P=0.011).2.Involved region,initial or recurrent disease and multiple tumors were included in the multivariate Cox regression analysis.The results showed that only initial or recurrent disease had a statistically significant effect on postoperative RFS of AF patients(P=0.015),which was an independent influencing factor of postoperative RFS of patients.3.Data was stratified according to whether the patients were initially treated or not,and Kaplan-Meier method was used to analyze the effect of postoperative adjuvant radiotherapy on postoperative RFS of patients with AF.The results showed that there was no statistically significant difference in RFS between the recurrence group and the non-recurrence group in terms of adjuvant radiotherapy group,whether the patients were initially treated or not(P>0.05).Conclusions1.Gender,age,maximum linear dimension,multiple tumors,history of trauma and postoperative adjuvant radiotherapy had no statistical significance on postoperative recurrence of AF patients.2.The involved region is the influencing factor of postoperative recurrence in AF patients.The risk of recurrence was higher in the extremities and lower in the abdominal wall.3.Initial or recurrent disease was an independent influencing factor for postoperative recurrence in AF patients,and the recurrence risk of non-newly treated patients was about 2.249 times that of newly treated patients(95%CI 1.090～4.639).However,whether initally treated or not,patients did not benefit from adjuvant postoperative radiotherapy in terms of reducing the risk of postoperative recurrence.