93009-114

Desmoid fibromatosis and pregnancy: A multi-institutional analysis of recurrence and obstetric risk.

Subcategory: 
Category: 
Sarcoma
Session Type and Session Title: 
Poster Discussion Session, Sarcoma
Abstract Number: 

10017

Citation: 
J Clin Oncol 30, 2012 (suppl; abstr 10017)
Author(s): 
Marco Fiore, Sara Coppola, Chiara Colombo, Monica M. Bertagnolli, Suzanne George, Axel Le Cesne, Paolo Giovanni Casali, Alessandro Gronchi, Sylvie Bonvalot, Chandrajit P. Raut; Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Institute Gustave Roussy, Villejuif, France; Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy; Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Department of Medical Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Institut Gustave Roussy, Villejuif, France

Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy are designated with a caret symbol (^).

Abstract Disclosures

Abstract: 

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.
A B C D
Total number 17 10 29 19
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
Medical therapy 4 - 2 1
DF progression after definitive treatment 3 (18%) 1 (10%) 8 (28%) 3 (16%)
Spontaneous regression 1 (5%) 1 (10%) 7 (24%) 1 (5%)