PURPOSE: @entity765 have a high propensity for local recurrence with surgical resection. There are many reports describing good responses of @entity765 to irradiation, but none have clearly established the indications for adjuvant radiotherapy in treating resectable @entity765 . METHODS AND MATERIALS: A retrospective analysis was performed on 61 @entity1 with resectable @entity765 (s) who were treated at our institution from 1965 to February of 1992. Five @entity1 had @entity66 and are analyzed separately. Fifty-six @entity1 had @entity66 , of which 34 had positive surgical margins. Forty-five of the 56 @entity1 with @entity66 were treated with surgery alone, while 11 were treated with surgery plus adjuvant radiotherapy. Median follow-up was 6 years. Local control was measured from the last day of treatment, and all cases were reviewed by our Department of Pathology. RESULTS: Multivariate analysis of the 56 @entity1 with @entity66 revealed that positive margins independently predicted for local recurrence (p < or = 0.01). Only 3 of 22 @entity1 with clear margins experienced a local recurrence, with a 6-year actuarial local control of 85%. Multivariate analysis of the 34 @entity1 with positive margins revealed that adjuvant radiotherapy independently predicted for improved local control (p = 0.01), and @entity1 with recurrent disease had a slightly higher risk of local recurrence (p = 0.08). The 6-year actuarial local control determined by Kaplan-Meier for @entity1 with @entity66 and positive margins was 32% (+/-12%) with surgery alone, and 78% (+/-14%) with surgery plus adjuvant radiotherapy (p = 0.02). Subgroup analysis of the @entity1 with positive margins and recurrent disease revealed that those treated with surgery alone had a 6-year actuarial local control of 0% vs. 80% for those treated with surgery plus radiotherapy (p < or = 0.01). @entity1 with positive margins and @entity66 had a trend towards improved local control with adjuvant radiotherapy, but this was not statistically significant. None of the @entity1 treated with radiotherapy developed serious complications or a secondary malignancy. CONCLUSIONS: Margin status is the most important predictor of local recurrence for @entity1 with resectable, unifocal @entity765 . Adjuvant radiotherapy is indicated in the treatment of @entity1 with positive margins following wide excision of recurrent disease. The role of adjuvant radiotherapy in @entity1 with positive margins following resection of @entity66 is controversial, and should be based on a balanced discussion of the potential morbidity from radiotherapy compared to the potential morbidity of another local recurrence. Adjuvant radiotherapy is less likely to benefit those with clear margins due to the excellent results for these @entity1 treated with surgery alone. The local control of @entity765 in the adjuvant setting is excellent with total doses ranging from 50-60 Gy, with acceptable morbidity. Field sizes should be generous to prevent marginal recurrences, and large volume MRIs of @entity1 with @entity75 should be used to identify those @entity1 with @entity66 .

The role of adjuvant radiotherapy in the treatment of resectable XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity765 :: ('MESH:D018222', 'Disease') :: ['Desmoid tumors', 'desmoid tumor', 'desmoid tumors'] @entity75 :: ('MESH:D001927', 'Disease') :: ['extremity lesions'] @entity66 :: ('MESH:D004194', 'Disease') :: ['unifocal disease', 'primary disease', 'multifocal disease']
@entity765 :: (MESH:D018222,Disease) :: ['desmoid tumors']
