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Oncology

FUNCTIONAL OUTCOME IN 43 PATIENTS POST-RESECTION OF FIBROMATOSIS WITH AND WITHOUT RADIOTHERAPY

British Orthopaedic Oncology Society (BOOS) - 2011 Annual Scientific Meeting



Abstract

Introduction

Fibromatosis is a disorder characterised by a spectrum of biological behaviour from relative indolence to aggressive local infiltration. With aimed to describe the pre and post-operative functional status of these patients managed with surgery and analyse the effect of radiotherapy on functional outcome.

Methods

43 patients were analysed in the upper and lower limb fibromatosis database in which functional data was available pre-op and at a minimum of two years post-op. Any plantar, palmer, chest or abdominal lesion was excluded as were hormonal or chemotherapy treated patients.

Results

20 men and 23 women aged from 18 to 71 with a median age of 44 were analyzed. 36 patients had no prior resective operative intervention. 7 patients had undergone an attempted resection procedure at another unit of which 7 had locally recurred. 40 of the lesions were classified as deep and 3 superficial. 17 were located in the lower limb and 26 upper in the limb. XRT was used in 2 in the post-operative period, 35 in the pre-operative period and 6 patients did not receive XRT. 16 operations produced a margin negative resection and 27 were positive. Follow-up ranged from 24 to 168 months. In the upper limb the median MSTS score was 86.6 (range 50-100) and the TESS was 93 (range 56-100). In the lower limb the median MSTS was 90.8 (range 71-100) and the TESS 89.2 (range 58-100).

There were no significant predictors for pre and post-op TESS patient reported outcomes. The MSTS post-op score was significantly associated with the pre-op score (p=0.01).

Conclusions

The best predictor of the post-op MSTS value is the pre-op score in the resection of fibromatosis. Radiation does not have a significant effect on the functional outcome of patients treated surgically for fibromatosis at a minimum of two years follow-up.