To investigate the clinical features and the efficacy of radical surgical resection in the treatment of aggressive fibromatosis (AF) of abdominal wall. Methods The clinical and follow-up data of 80 patients with AF of abdominal wall admitted to the Department of Gastrointestinal Surgery of Shandong Provincial Hospital between January 2011 and January 2024 were retrospectively analyzed, and the surgical details, short- and long-term outcomes, pathological features, and factors associated with recurrence were statistically analyzed. Results Four patients (5%) underwent simple tumor excision, 69 patients (86.25%) underwent radical tumor resection plus abdominal wall reconstruction, 5 patients (6.25%) underwent combined tumor and organ resection plus abdominal wall reconstruction, and 2 patients underwent tumor resection plus autologous tissue transplantation plus abdominal wall reconstruction. The operative time was 165 (25-725) minutes, and intraoperative blood loss was 35 (5-250) mL. Postoperatively, 2 patients (2.5%) developed abdominal wall infection, and 3 patients (3.75%) developed abdominal wall hernia or bulging. The median postoperative follow-up was 60 (7-163) months. Three patients experienced recurrence, for a recurrence rate of 3.8%. Among all patients, 63 completed abdominal wall function grading, and 87.3% had no obvious limitations in physical activity (abdominal wall function grade 4 or 5). One patient (1.25%) died due to rapid tumor enlargement invading multiple intra-abdominal organs after multiple surgeries. Recurrent-type AF and positive surgical margins were significantly associated with postoperative recurrence (P<0.05); multivariable analysis indicated that recurrent-type AF was an independent risk factor for postoperative re-recurrence (P=0.011). Conclusion Abdominal wall AF is more common in young women, with most patients having a history of abdominal surgery. Recurrent cases are prone to postoperative recurrence. Radical surgical resection combined with abdominal wall reconstruction is a safe, feasible and reliable method for the treatment of abdominal wall AF.
Key words
aggressive fibromatosis /
abdominal wall /
surgery /
recurrence
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