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Desmoid fibromatosis and pregnancy: A multi-institutional analysis of recurrence and obstetric risk.
Session Type and Session Title:
Poster Discussion Session, Sarcoma
J Clin Oncol 30, 2012 (suppl; abstr 10017)
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Background: Desmoid fibromatosis (DF) may be diagnosed during or after pregnancy (P). However, the risk of progression during P, or in women of child-bearing age with DF prior to P, is unknown. Furthermore, obstetric risks have not been well described. Methods: Institutional databases were reviewed at 3 sarcoma referral centers in Europe and US for women with sporadic DF from 1985 to 2011. Pregnancy and treatment data, outcomes, and obstetric complications were recorded. Results: Overall 75 women were identified. DF was diagnosed during P in 17 women (Group A) or within 6 mo after P in 10 (Group B), was in situ at the time of P in 29 women (Group C), or had been resected prior to P in 19 (Group D). Anatomic site, outcomes, and treatment for each group are in the Table. Among patients operated at diagnosis, 2/11 (18%) recurred (Group A+B). Among the entire cohort, 15 women (20%) recurred after definitive treatment and only 6 (8%) needed multiple treatments after P. Ten spontaneous regressions occurred after P (13%). Twelve women had further P following the DF-related one, and 3 (25%) needed treatment after the subsequent P. At a median follow up of 35 mo from P, 17 women did not receive any treatment (23%), and 39 remain disease-free (52%). Caesarean section was needed in 14 cases (19%), but only in 1 expressly due to DF. DF-related P was associated with abortion in 6 cases (4 spontaneous, 2 voluntary); in no case was it caused by the presence of DF. Conclusions: DF developing prior to or during P may progress during the course of P or thereafter. Spontaneous regression after P was also observed. When resected, P-related DF rarely recurs. Wait & see is an option as well. DF history is not an indication for therapeutic abortion nor a contraindication against subsequent P.
|Abdominal wall||11 (64%)||6 (60%)||14 (48%)||14 (73%)|
|Limbs||1 (6%)||2 (20%)||11 (38%)||2 (11%)|
|Visceral||4 (24%)||2 (20%)||1 (4%)||2 (11%)|
|Other||1 (6%)||0||3 (10%)||1 (5%)|
|Primary / recurrent||17/0||10/0||19/10||17/2|
|DF progression during or after P||12 (70%)||-||16 (55%)||4 (21%)|
|Treatment after progression||9 (53%)||-||8 (28%)||3 (16%)|
|Surgery (*1 ILP)||5||-||6*||2|
|DF progression after definitive treatment||3 (18%)||1 (10%)||8 (28%)||3 (16%)|
|Spontaneous regression||1 (5%)||1 (10%)||7 (24%)||1 (5%)|
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