TY - JOUR
T1 - Association between recent pregnancy or hormonal contraceptive exposure and outcome of desmoid-type fibromatosis
AU - Debaudringhien, M.
AU - Blay, J. Y.
AU - Bimbai, A. M.
AU - Bonvalot, S.
AU - Italiano, A.
AU - Rousset-Jablonski, C.
AU - Corradini, N.
AU - Piperno-Neumann, S.
AU - Chevreau, C.
AU - Kurtz, J. E.
AU - Guillemet, C.
AU - Bompas, E.
AU - Collard, O.
AU - Salas, S.
AU - Le Cesne, A.
AU - Orbach, D.
AU - Thery, J.
AU - Le Deley, M. C.
AU - Mir, O.
AU - Penel, N.
N1 - Publisher Copyright:
© 2022 The Author(s)
PY - 2022/10/1
Y1 - 2022/10/1
N2 - Background: The role of both hormonal contraception and pregnancy on the outcomes of desmoid-type fibromatosis (DF) is debatable. Materials and methods: In the present study, we selected female patients of childbearing age from the prospective ALTITUDES cohort. The primary study endpoint was event-free survival (EFS), with an event defined as relapse or progression. We estimated the risk of events according to the use of hormonal contraception [estrogen–progestin (EP) and progestin] and pregnancy status using multivariate time-dependent models, controlling for major confounders. Results: A total of 242 patients (median age, 34.7 years) were included in the present study. The abdominal wall was the most common tumor site (51%). Patients were managed by active surveillance (80%) or surgery (20%). Pregnancy occurred within 24 months before, at the time of, and after DF diagnosis in 33%, 5%, and 10% of the cases, respectively. Exposure to hormonal contraception was documented within 24 months before, at the time of, and after diagnosis in 44%, 34%, and 39% of the cases, respectively. The 2-year EFS was 75%. After adjusting for DF location, tumor size, front-line treatment strategy, and hormonal contraception, we observed an increased risk of events occurring at 24 months after pregnancy [hazard ratio (HR) = 2.09, P = 0.018]. We observed no statistically significant association between the risk of events and current EP exposure (HR = 1.28, P = 0.65), recent EP exposure (within 1-24 months, HR = 1.38, P = 0.39), current progestin exposure (HR = 0.81, P = 0.66), or recent progestin exposure (HR = 1.05, P = 0.91). Conclusions: In our study, a recent history of pregnancy was associated with an increased risk of progression/relapse in patients with newly diagnosed DF, whereas hormonal contraception did not demonstrate an association with progression/relapse.
AB - Background: The role of both hormonal contraception and pregnancy on the outcomes of desmoid-type fibromatosis (DF) is debatable. Materials and methods: In the present study, we selected female patients of childbearing age from the prospective ALTITUDES cohort. The primary study endpoint was event-free survival (EFS), with an event defined as relapse or progression. We estimated the risk of events according to the use of hormonal contraception [estrogen–progestin (EP) and progestin] and pregnancy status using multivariate time-dependent models, controlling for major confounders. Results: A total of 242 patients (median age, 34.7 years) were included in the present study. The abdominal wall was the most common tumor site (51%). Patients were managed by active surveillance (80%) or surgery (20%). Pregnancy occurred within 24 months before, at the time of, and after DF diagnosis in 33%, 5%, and 10% of the cases, respectively. Exposure to hormonal contraception was documented within 24 months before, at the time of, and after diagnosis in 44%, 34%, and 39% of the cases, respectively. The 2-year EFS was 75%. After adjusting for DF location, tumor size, front-line treatment strategy, and hormonal contraception, we observed an increased risk of events occurring at 24 months after pregnancy [hazard ratio (HR) = 2.09, P = 0.018]. We observed no statistically significant association between the risk of events and current EP exposure (HR = 1.28, P = 0.65), recent EP exposure (within 1-24 months, HR = 1.38, P = 0.39), current progestin exposure (HR = 0.81, P = 0.66), or recent progestin exposure (HR = 1.05, P = 0.91). Conclusions: In our study, a recent history of pregnancy was associated with an increased risk of progression/relapse in patients with newly diagnosed DF, whereas hormonal contraception did not demonstrate an association with progression/relapse.
KW - desmoid-type fibromatosis
KW - hormonal contraception
KW - hormone-dependency tumor
KW - outcome
KW - pregnancy
UR - http://www.scopus.com/inward/record.url?scp=85139192385&partnerID=8YFLogxK
U2 - 10.1016/j.esmoop.2022.100578
DO - 10.1016/j.esmoop.2022.100578
M3 - Article
C2 - 36116422
AN - SCOPUS:85139192385
SN - 2059-7029
VL - 7
JO - ESMO Open
JF - ESMO Open
IS - 5
M1 - 100578
ER -