Surgical Outcomes in Fibromatosis: A Single-Centre Outcomes.

Abstract

Background: Fibromatosis is a rare, benign, yet locally aggressive monoclonal fibroblastic proliferation. While current management paradigms increasingly favour non-operative strategies to avoid surgical morbidity and high recurrence rates, the role of surgery remains debated.

Objective: This study aimed to evaluate the clinical presentation, management strategies, and oncological outcomes of fibromatosis at a single tertiary care centre.

Methods: We conducted a retrospective, observational study of patients with histologically confirmed fibromatosis treated between January 2006 and September 2021. Data on patient demographics, tumour characteristics, treatment modalities, and disease status at last follow-up were analysed.

Results: Of 57 identified patients, 33 had complete records and were included. The cohort was predominantly female (81.82%) with a median age at diagnosis of 25 years. The most common site was the lower limb (mid-leg). The majority (93.94%) of tumours were deep to the fascia. Surgery was the primary treatment in 75.76% of patients, with wide, marginal, and intralesional resections performed in 72%, 24%, and 4% of cases, respectively. At a mean follow-up of 80 months, the progression-free rate for patients treated with primary surgery was 72% (18/25), compared to 87.5% (7/8) for those managed primarily with non-operative strategies (active surveillance or systemic therapy). Overall, 75.76% of patients were disease-free. Statistical analysis revealed no significant correlation between disease-free status and the type of surgical procedure (p = 0.45), surgical margin status (p = 0.72), or tumour location (p = 0.61).

Conclusion: In our cohort, both surgery and initial non-operative management resulted in favourable medium-term disease control. Although not statistically significant in this small cohort, a trend towards higher recurrence was observed with marginal (50%) compared to wide (22%) margins. Our data suggest that in selected patients, less radical resection may be a viable option to reduce morbidity, but wider margins may be preferable when feasible without functional compromise. These findings contribute to the ongoing reevaluation of management strategies for fibromatosis.