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Most desmoid tumors are sporadic, but others are associated with syndromes like familial adenomatous polyposis, and their management differs due to their peculiarities.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Surgery has classically been the basic pillar of treatment, and the aim is to achieve complete resection. However, systematic indication for surgery has been called into question by the high rate of local recurrences, together with the considerable morbidity of the surgical procedure, lack of metastatic capacity of these tumors, and the possibility of complete spontaneous regression (up to half of cases, even without treatment).<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5–7</span></a> As a result, the therapeutic approach has changed towards a multidisciplinary model that incorporates targeted medical or hormonal therapies, which are much less invasive options.</p><p id="par0015" class="elsevierStylePara elsevierViewall">In this context, the Desmoid Tumor Working Group<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> has created a consensus document that discusses the prospect of adopting an active, personalized surveillance strategy as an initial option, instead of systematic surgical resection. This scenario, together with emerging therapies with promising results, such as cryoablation and gamma-secretase inhibitors,<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9–12</span></a> makes it essential for the management of these patients to be done in specialized centers, by an experienced multidisciplinary team that includes surgeons, oncologists, radiotherapists, pathologists, etc. Thus, correct indication for surgery takes on maximum relevance and becomes equally important as the surgical technique itself.</p><p id="par0020" class="elsevierStylePara elsevierViewall">In this scenario, the indication for surgery has not ended in desmoid tumors, but the role of the surgeon must change radically. Surgery remains the most important option in many cases, but it is no longer systematic. Far from losing protagonism, surgeons need to acquire greater biological knowledge about the disease and non-surgical alternatives that include active, personalized monitoring in order to reduce postoperative morbidity.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:12 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of desmoid tumours: a nationwide survey of labelled reference centre networks in France" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "N. Penel" 1 => "J.M. Coindre" 2 => "S. 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Journal Information
Vol. 102. Issue 8.
Pages 464-465 (August 2024)
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Vol. 102. Issue 8.
Pages 464-465 (August 2024)
Letter to the Editor
Has the surgical indication for desmoid tumors ended?
¿Se ha acabado la indicación quirúrgica en los tumores desmoides?
Vicente Olivares-Ripoll
, Elena Gil-Gómez, Alida González-Gil, Pedro Antonio Cascales-Campos
Corresponding author
Cirugía General y digestiva. Hospital Clínico Universitario Virgen de la ArrixacaCtra. Madrid-Cartagena, El Palmar, Murcia
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