Active surveillance in desmoid-type fibromatosis: A systematic literature review
Background: This study evaluates the results of the active surveillance (AS) approach in adult patients with desmoid-type fibromatosis (DTF) because AS is advocated as a front-line approach for DTF in the European consensus guidelines. Methods: A systematic literature search was conducted (December 19th, 2019, updated on April 14th, 2020). Studies describing the outcomes of the AS approach were included. The PRISMA guidelines were used. Results: Twenty-five articles were included for data retrieval. Forty-two percent of reported patients (1480 of 3527 patients) received AS, the majority were women and the majority had a primary tumour. The median age at diagnosis ranged from 28 to 59 years. Common tumour sites were the extremities/girdles (n = 273), the abdominal wall (n = 253) and the trunk (n = 153). The median reported percentage of progressive disease, stable disease and partial response was 20% (interquartile range [IQR]: 13–35%), 59% (IQR: 37–69%) and 19% (IQR 3–23%), respectively. In 640 patients, the outcome was not specified. The median reported percentage of shifting to an active form of treatment was 29%, most commonly to systemic treatment (n = 195) and surgery (n = 107). The reported median follow-up time ranged between 8 and 73 months. The reported median time to progression and/or initiation of the subgroup shifting from AS to ‘active’ therapy ranged from 6.3 months to 19.7 months. Conclusion: The majority of patients undergoing AS have either stable disease or a partial response, and about one-third of patients shift to an active form of treatment. Selecting patients who will benefit from active surveillance upfront should be the priority of future studies.
|Keywords||Active surveillance, Fibromatosis, Aggressive, Observation, Response Evaluation Criteria in Solid Tumours, Sarcoma, Treatment outcome, Watchful waiting|
|Persistent URL||dx.doi.org/10.1016/j.ejca.2020.06.022, hdl.handle.net/1765/129641|
|Journal||European Journal of Cancer|
Timbergen, M.J.M. (Milea J.M.), Schut, A.-R.W. (Anne-Rose W.), Grunhagen, D.J, Sleijfer, S, & Verhoef, C. (2020). Active surveillance in desmoid-type fibromatosis: A systematic literature review. European Journal of Cancer (Vol. 137, pp. 18–29). doi:10.1016/j.ejca.2020.06.022