%0 Journal Article
%T A Novel Method to Treat Progressive Desmoid Tumors Involving Neurovascular Bundles: A Retrospective Cohort Study.
%A Yin JQ
%A Fu YW
%A Gao ZH
%A Zou CY
%A Xie XB
%A Wang B
%A Zhong ZH
%A Huang G
%A Shen JN
%J Neurosurgery
%V 88
%N 6
%D 05 2021 13
%M 33556169
%F 5.315
%R 10.1093/neuros/nyaa589
%X More effective therapies are needed to treat progressive desmoid tumors when active surveillance and systemic therapy fail.<BR>To assess the efficacy and safety of sandwich isolation surgery on the local control of progressive desmoid tumors involving neurovascular bundles.<BR>A total of 27 patients with progressive desmoid tumors at extremities involving neurovascular bundles who received surgery at our hospital between August 2014 and August 2018 were identified. A total of 13 patients received sandwich isolation surgery, in which R2 resection was performed in neurovasculature-involving regions, and a biomaterial patch was used to envelop involved neurovascular structures and isolate residual tumors. In non-neurovasculature-involving regions, wide resection was performed without isolation. A total of 14 patients received traditional surgery, which included tumor resection without isolation procedure.<BR>In sandwich isolation group, tumor progressions and local recurrences occurred in 3 patients outside the isolated neurovasculature-involving regions. However, no progressions or recurrences occurred in any patients in the isolated neurovasculature-involving regions where R2 resection was performed. Sandwich isolation surgery group and traditional surgery group shared similar baseline clinical characteristics. The estimated 3-yr event-free survival rate was 76.9% after sandwich isolation surgery, and 32.7% after traditional surgery (P = .025). Patients who received sandwich isolation surgery were less likely to have local recurrence (hazard ratio: 0.257, P = .040). No complications were noted except intermittent mild pain in operative regions (2 cases).<BR>Sandwich isolation surgery is effective and safe for local control of desmoid tumors involving neurovascular bundles.