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5.1 Treatment with surgery

Chart 5.1.1

maps the treatment options for desmoid

tumors that can be treated with surgery. Some

tumors are small enough, aren’t causing symptoms,

and are located where an increase in size won’t

cause problems. For these tumors, you may start

observation. Observation is a period of testing to

watch for tumor growth so that treatment can be

started if needed.

Large tumors that are causing problems should be

treated based on where the tumor is and the possible

outcomes of treatment. Options include surgery with

or without radiation therapy, chemotherapy, or both.

Other options are radiation therapy or drug therapy

without other treatments.

You may receive more treatment after primary

treatment. If the tumor is all gone, you may start

observation. For large tumors, radiation therapy after

surgery can be given if you did not receive it before


There are three options if most of the tumor was

removed but tiny amounts that can’t be seen remain.

These options are a second surgery, radiation

therapy, or observation.

Tumors that can still be seen after treatment have

four options for treatment. Radiation and drug therapy

are two options. If neither works, surgery to remove

the visible tumor may be done. Lastly, observation

can be done, and when the tumor grows you can start


NCCN Guidelines for Patients


Soft Tissue Sarcoma, Version 1.2014



Desmoid tumors

Treatment with surgery

Chart 5.1.1 Treatment options

Primary treatmemt

Treatment results

Adjuvant treatment

Surgery ± radiation

therapy ± drug therapy

Radiation therapy

Drug therapy

Tumor fully gone

Some tumor remains

but can’t be seen

Some tumor remains

and can be seen

Consider second surgery,

Radition therapy if none prior, or


Observation, or

Consider radiation if large tumor

Radiation therapy,

Drug therapy,

Surgery if all else fails


Observation if small tumor

Options for all tumors: