Desmoid tumor
ICD-10 D48.1 · ICD-11 2F7C

Desmoid Tumor of the Extremity, Girdles, or Chest Wall — When Active Surveillance Fails to Control Tumor Growth

This protocol addresses patients with desmoid tumor located at the extremity, the shoulder or pelvic girdles, or the chest wall, specifically in the setting where initial active surveillance has not maintained stable disease.

Prior Treatment — Surveillance Did Not Achieve Goals

The initial management strategy was active surveillance with regular clinical and imaging follow-up. Escalation to this protocol is indicated when surveillance failed to sustain:

Next-Step Treatment Approach

For tumors that have exceeded surveillance thresholds, the protocol moves to active intervention. This includes local ablative therapy as one option, alongside systemic medical treatments spanning more than one therapeutic class.

Treatment success is assessed by absence of disease progression on imaging at 6 months, tumor non-progression at 12 months after local therapy, and improvement in pain and functional status. Specific agent selection, sequencing, and the complete regimen are detailed in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1001/jamaoncol.2024.1805

Cryoablation has been reported in case series to be an effective alternative treatment for small and moderately sized extra-abdominal DT.

Cryoablation appears to be a promising local treatment option for DT.

The consensus of the Desmoid Tumor Working Group was that for most of the available treatments, a course of at least 6 months is required (provided there is absence of frank progression) prior to assessing effectiveness.

Cryoablation was associated with improved functional status and pain scores.

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