硬纤维瘤 (DT) 是一种罕见的成纤维细胞增殖，可以表现出局部侵袭行为，但缺乏转移潜力。传统上，初始治疗涉及前期切除；然而，当代指南和专家小组越来越主张优先考虑主动监测策略。一项单一机构回顾性图表审查确定了 2007 年至 2020 年期间在任何地点诊断为原发性 DT 的所有患者。主要结果是随时间推移的初始管理策略。次要结局包括接受主动监测的患者的无治疗生存期 (TFS) 和治疗时间 (TTT)，以及接受切除的患者的无复发生存期 (RFS) 和至复发时间。总共纳入了 103 名患者，其中68% 为女性，中位随访时间为 44 个月 [24-74]。最常见的肿瘤位置包括腹壁（27%）、腹腔内/肠系膜（25%）、胸壁（19%）和四肢（10%）。初始治疗包括切除（60%）、全身治疗（20%）、主动监测（18%）和冷冻消融（2%）。随着时间的推移，手术切除率显着下降 (p < 0.001)，从 2018 年之前的 69.6% 降至 2018 年之后的 29.2%。对于接受前期切除治疗的患者，5 年 RFS 为 41.2%，对于接受初始主动监测的患者，TFS 为 41.2% 2 年时为 66.7%，中位 TTT 为 4 个月 [4-10]。这个在三级医疗中心进行的跨十多年的单一机构队列展示了 DT 初始管理向主动监测的过渡，并强调了显着指标在监控时代。这一趋势反映了专家小组推荐的治疗策略和共识指南。© 2024。外科肿瘤学会。

Desmoid tumors (DTs) are rare, fibroblastic cell proliferations that can exhibit locally aggressive behavior but lack metastatic potential. Initial management has traditionally involved upfront resection; however, contemporary guidelines and expert panels have increasingly advocated for prioritizing active surveillance strategies.A single-institution, retrospective chart review identified all patients diagnosed with a primary DT at any site from 2007 to 2020. The primary outcome was the initial management strategy over time. Secondary outcomes included treatment-free survival (TFS) and time to treatment (TTT) for those undergoing active surveillance, as well as recurrence-free survival (RFS) and time to recurrence for those undergoing resection.Overall, 103 patients were included, with 68% female and a median follow-up of 44 months [24-74]. The most common tumor locations included the abdominal wall (27%), intra-abdominal/mesenteric (25%), chest wall (19%), and extremity (10%). Initial management included resection (60%), systemic therapy (20%), active surveillance (18%), and cryoablation (2%). Rates of surgical resection significantly decreased (p < 0.001) over time, from 69.6% prior to 2018 to 29.2% after 2018. For those treated with upfront resection, 5-year RFS was 41.2%, and for patients undergoing initial active surveillance, TFS was 66.7% at 2 years, with a median TTT of 4 months [4-10].This single-institution cohort at a tertiary medical center spanning over a decade demonstrates the transition to active surveillance for initial management of DTs, and highlights salient metrics in the era of surveillance. This trend mirrors recommended treatment strategies by expert panels and consensus guidelines.© 2024. Society of Surgical Oncology.