Clinical Features And Prognosis Of Abdominal Invasive Fibromatosis

Objective To summarize the diagnosis and treatment experience of invasive fibromatosis of the abdomen and explore the factors affecting its prognosis.Data and Methods A retrospective analysis of 42 patients with pathologically confirmed abdominal invasive fibromatosis admitted to the Affiliated Hospital of Qingdao University from January 2007 to December 2017 was performed.Patients were followed up to analyze the affected tumors.Recurrence related factors.Results All 42 patients were followed up for 6-124 months.The median follow-up time was 62 months.A total of 10 relapses occurred.The recurrence rate was 23.80%(10/42).All patients relapsed within 5 years.The recurrence time was 6-52 months postoperatively with a mean recurrence time of 20.3 months and a median recurrence time of 15 months.According to the different recurrence periods,4 cases relapse within 1 year,the recurrence rate was 9.50%,8 cases recurred within 3 years,the recurrence rate was 19.00%,10 cases recurred within 5 years,and the recurrence rate was 23.80%.In all cases,there were 10 males,accounting for 23.8% of the total,and 32 females,accounting for 76.2% of the total.The male to female ratio was 1:3.2.The age range is 2-84 years,with an average of 35.43 persons and 14.409 years,with a median age of 33.50 years.42 The main clinical manifestations of patients with abdominal invasive fibromatosis were abdominal masses found in the examination,accounting for 59.5%,or most patients had no obvious symptoms,accounting for 66.7%.Of the 42 patients,34 cases were newly diagnosed,accounting for 81.0% of the total,5 cases relapsed,accounting for 14.7% of newly diagnosed patients,8 cases of postoperative recurrences in the external hospital,accounting for 19.0% of the total,and 5 cases relapsed after surgery in our hospital.Accounted for 62.5%.According to the surgical method,27 patients underwent extended resection.One,two,and three cases relapsed after 1 year,3 years,and 5 years respectively;12 patients underwent simple tumor resection and 1 case,3 years,and 5 years recurred respectively.Cases and 4 cases;partial resection of tumor in 3 cases,1 year,3 years,5 years recurrence in 2 cases,3 cases and 3 cases,the difference between the three was statistically significant;according to margin conditions,microscopic negative margin(R0)In 26 cases,0,1 and 2 cases recurred in 1 year,3 years and 5 years respectively;13 cases were positive in the margin(R1);2 cases,4 cases were relapsed in 1 year,3 years,and 5 years respectively.Five cases were positive(R2)in 3 cases,and 2 cases,3 cases and 3 cases recurred in 1 year,3 years and 5 years respectively.The differences among the three groups were statistically significant.According to the results of univariate analysis,the factors affecting the recurrence rate of patients with invasive fibromatosis of the abdomen at 1 year,3 years,and 5 years include: tumor diameter,tumor site,surgical method,first diagnosis of the patient,and surgical resection margin.The recurrence-free survival rate of 42 cases of abdominal invasive fibromatosis was analyzed by Log-Rank univariate analysis.The results showed that tumor diameter,surgical method,first diagnosis of patients and surgical margins were the factors affecting the recurrence of patients with abdominal invasive fibromatosis.The difference was statistically significant,P<0.05.Multivariate analysis of COX model revealed that tumor diameter and surgical margins were independent risk factors for postoperative recurrence in patients with abdominal invasive fibromatosis(P<0.05).Based on surgical margins,Fisher's exact probability method was used to compare between negative margin(R0),positive margin(R1),and positive margin(R2),R0,R1,R2,R0,and R1.The difference between the R0 group and the R2 group was statistically significant at P<0.05.The difference between the R1 group and the R2 group was P=0.200>0.05.The difference was not statistically significant.in conclusion1?There are no specific clinical signs and symptoms in early stage of abdominal invasive fibromatosis and it is difficult to find and diagnose early.2?Independent risk factors affecting the recurrence of abdominal invasive fibromatosis include: tumor diameter,surgical margin conditions.3?The best treatment for invasive fibromatosis of the abdomen is surgical enlargement.No matter the diameter of the tumor,the resection is enlarged and the margin is negative for the first time.