Royal College of Surgeons in Ireland
Surgical management of abdominal desmoids a systematic review and meta-analysis.pdf (836.09 kB)

Surgical management of abdominal desmoids: a systematic review and meta-analysis

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posted on 2024-05-07, 15:55 authored by David MooreDavid Moore, Lucy Burns, Ben Creavin, Eanna RyanEanna Ryan, Kevin Conlon, Michael Eamon Kelly, Dara KavanaghDara Kavanagh
Background: Desmoid tumours are benign fibromatous tumours arising from dysregulated myofibroblast proliferation within musculoaponeurotic structures. They can occur sporadically but more commonly are associated with genetic syndromes such as familial adenomatous polyposis (Sakorafas et al. in Surg Oncol 16(2):131-142, 2007) (FAP). Mutations in either the Wnt, β-catenin or APC genes are 'key' triggers for the development of these tumours (Howard and Pollock in Oncol Ther 4(1):57-72, 2016). Classically, these tumours do not metastasise; however, they are associated with significant morbidity and mortality due to their infiltrative pattern and/or local invasion. Historically, surgical resection was the cornerstone of treatment. There remains paucity of data regarding outcomes following the surgical management of abdominal desmoid tumours in terms of success, recurrence and morbidity.
Objectives: The aim of this review was to assess the current evidence for surgical management of abdominal desmoid tumours in terms of success, recurrence and morbidity.
Methods: A systematic search of articles in PubMed, EMBASE and The Cochrane Library databases was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for the period from January 2000 to November 2020.
Results: Twenty-three studies were included, of which, 749 patients had surgical resection (696 for primary and 53 for recurrent desmoids), 243 patients (18.8%) were medically managed and 353 patients (27.3%) underwent surveillance. Median follow-up was 51.4 months (range 1-372). Six-hundred and ninety-six of the 749 resections (92.9%) underwent primary desmoid resection, with the remaining 53 (7.1%) undergoing resection for recurrence. One-hundred and two surgically managed patients (19%) developed a (re)recurrence, with mesenteric involvement the commonest site for recurrence (55%). When comparing recurrence post-surgery to progression following medical therapy, there was a trend towards better outcomes with surgery, with 25% of surgical patients having a recurrence versus 50.5% having progression with medical therapy [OR 0.40 (95% CI 0.06-2.70), p = 0.35]. Major morbidity following surgery was 4.4% (n = 33) with 2% (n = 14) mortality within 30 days of resection.
Conclusion: The management of desmoids has considerable heterogeneity. Surgical resection for abdominal desmoids remains a valid treatment option in highly selective cases where negative margins can be obtained, with low major morbidity and/or mortality.


Open Access funding provided by the IReL Consortium


Data Availability Statement

All data generated or analysed during this study are included in this article, the reference section and its supplementary material files. Further enquiries can be directed to the corresponding author.


The original article is available at

Published Citation

Moore D, et al. Surgical management of abdominal desmoids: a systematic review and meta-analysis. Ir J Med Sci. 2022;192(2):549-560.

Publication Date

21 April 2022

PubMed ID



  • Physiology and Medical Physics
  • Surgical Affairs


Springer Nature


  • Published Version (Version of Record)