Chemoprophylaxis against the onset of DTs has been suggested even if no data are reported in the literature. The ideal drug should be active in a large number of cases and have a favourable therapeutic index. Both NSAIDs and SERMs seem to have these characteristics, and raloxifen has no major side effects. All the FAP patients submitted to abdominal surgery who have a family history for DTs or a 3' APC mutation are candidates for a pharmacological prophylaxis. In our opinion, the patients in whom PDLs are found at surgery should also be submitted to chemo-prophylaxis.
Our experience is detailed in Tables 4 and 5. The 20 patients with a DPL or a fibromatosis of the mesenteric fold were treated with tamoxifen or ralox-ifen and followed up for a mean time of 65 months and 79 months, respectively. No progression of the desmoid disease was observed in any patient and the lesions completely regressed in two patients after closure of the protective ileostomy.
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