Four different treatment strategies in aggressive fibromatosis: A systematic review.

•Relative good overall local control rate of all four different treatment groups of  >75%.•Multivariate analysis shows deep seated tumors, age (<30 years) and extracompartmentally situated tumors as negative predicting markers of local outcome.•The radiotherapy alone group did not have better local control rates than the observation group (p = 0.355).•In case of recurrent disease, adjuvant radiotherapy has a definite advantage over surgery alone (p = 0.001).•Radiotherapy alone gives in 50% of cases partial or complete regression, and in 14% complete regression. Eventually 23% develop local progression.•Observation could be considered as first line treatment in patients with tumors not in close adherence to important structures and no symptoms.•Stabilization of the tumor arose after a median time of  >1 year after observation, and a local recurrence or progression occurred after a median time of <3 years.