The Selective Role of Surgery in Contemporary Desmoid Tumor Management

Surgery historically served as first line therapy for desmoid tumor. However, contemporary evidence has led to a paradigm shift. The panel discusses how high local recurrence rates, potential surgical morbidity, and the unpredictable natural history of desmoid tumor have reduced the role of upfront resection.

Surgical intervention may still be considered in highly selected scenarios, such as small, localized tumors in non critical anatomic locations where complete resection can be achieved with minimal functional compromise. Even in these situations, multidisciplinary discussion is essential to weigh risks and benefits. Recurrent disease after surgery can be challenging to manage and may ultimately result in greater morbidity than initial observation or systemic therapy.

The panel underscores that desmoid tumor does not metastasize, which shifts the therapeutic goal toward preserving function and quality of life. Rather than defaulting to surgery, clinicians are encouraged to confirm diagnosis, assess symptoms, and consider active surveillance or systemic options when appropriate. This segment highlights how evidence aligned care has transformed surgical decision making in desmoid tumor.