One hundred and ninety-four patients with extra-abdominal desmoid
tumors, most of them in the extremities, have been treated at the Mayo
Clinic. One hundred and thirty-two patients (68 per cent) experienced a
recurrence at an average of 1.4 years after the first treatment. A greater
tendency for recurrence was evident in female patients, in patients who
were more than thirty years old, in certain anatomical locations
(especially the foot and calf), and most importantly after treatment by
intralesional or marginal excision. In view of the excellent prognosis for
survival, we recommend wide local excision when anatomically feasible or
marginal excision and postoperative radiation therapy when function of the
extremity would be severely compromised if excision with wide margins were
done. A recurrent lesion that does not appear to be growing should be
followed until evidence of growth of the lesion precipitates a secondary
wide excision.