AI Article Synopsis

  • The study aimed to identify factors affecting progression-free survival (PFS) in aggressive fibromatosis (AF) patients after postoperative radiotherapy (PORT) and explore relationships between specific immunohistochemical markers and PFS.
  • The analysis included 37 patients treated with PORT, revealing a 5-year PFS rate of 70.9%, but showing that tumor size and margins didn't significantly influence PFS.
  • Key findings indicated that delaying PORT after surgery decreased PFS, and immediate PORT post-surgery improves outcomes, while β-catenin levels may have a potential link to local recurrence.

Article Abstract

Purpose: To identify prognostic factors influencing progression-free survival (PFS) of aggressive fibromatosis (AF) after postoperative radiotherapy (PORT) and assess correlations between immunohistochemistry (IHC) features of β-catenin/smooth muscle actin (SMA) and PFS.

Materials And Methods: Records of 37 patients with AF treated by PORT from 1984 to 2015 were retrospectively reviewed. Fifteen patients underwent wide excision for AF and 22 patients received debulking operation. The median total dose of PORT was 59.4 Gy. IHC staining results of β-catenin and SMA were available for 11 and 12 patients, respectively.

Results: The median follow-up duration was 105.9 months. Five-year PFS rate was 70.9%. Tumor size or margin status was not related to PFS in univariate analysis (p = 0.197 and p = 0.716, respectively). Multivariate analysis showed that increased interval from surgery to PORT (>5.7 weeks) was a marginal risk factor for PFS (p = 0.054). Administration of PORT at the initial diagnosis resulted in significantly improved PFS compared to deferring PORT after recurrence (p = 0.045). Patient with both risk factors of deferring PORT after recurrence and interval from surgery to PORT >5.7 weeks had significantly lower 5-year PFS than patients without risk factor (34.1% vs. 100.0%; p = 0.012). Nuclear β-catenin intensity tended to inversely correlate with 5-year PFS, although it did not reach statistical significance (62.5% at low vs. 100.0% at high; p = 0.260). SMA intensity was not related to PFS (p = 0.700).

Conclusion: PORT should be performed immediately after surgery irrespective of margin status or tumor size especially in recurrent case. Nuclear β-catenin staining intensity of IHC might correlate with local recurrence.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6453810PMC
http://dx.doi.org/10.3857/roj.2018.00542DOI Listing

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