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The Desmoid Tumor Research Foundation

September 2022

Association between recent pregnancy or hormonal contraceptive exposure and outcome of desmoid-type fibromatosis

Author Information

Debaudringhien M (1), Blay JY (2), Bimbai AM (3), Bonvalot S (4), Italiano A (5), Rousset-Jablonski C (6), Corradini N (7), Piperno-Neumann S (8), Chevreau C (9), Kurtz JE (10), Guillemet C (11), Bompas E (12), Collard O (13), Salas S (14), Cesne AL(15), Orbach D (16), Thery J (3), Le Deley MC (17), Mir O (15), Penel N (18).

(1) Lille University, Medical School, Lille, France. (2) Medical Oncology Department, Centre Léon Bérard, Lyon, France. (3) Clinical Research Department, Centre Oscar Lambret, Lille, France. (4) Department of Surgical Oncology, Institut Curie, Paris, France. (5) Medical Oncology Department, Institut Bergonié, Bordeaux, France. (6) Departments of Medical Oncology, Lyon, France. (7) Pediatric Oncology, Centre Léon Bérard, Lyon, France. (8) Medical Oncology Department, Institut Curie, Paris, France. (9) Medical Oncology Department, Institut Claudius Regaud, Oncopole, Toulouse, France. (10) Medical Oncology Department, Strasbourg University Hospital, Strasbourg, France. (11) Medical Oncology Department, Centre Henri Becquerel, Rouen, France. (12) Medical Oncology Department, Institut de Cancérologie de l'Ouest, Saint-Herblain, France. (13) Medical Oncology Department, Institut de Cancérologie de Loire, Saint-Priest-en-Jarez, France. (14) Medical Oncology Department, Hôpital La Timone University Hospital, Marseille, France (15) Medical Oncology Department, Gustave Roussy, Villejuif, France. (16) SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), PSL Research University, Institut Curie, Paris, France. (17) Clinical Research Department, Centre Oscar Lambret, Lille, France; CESP, INSERM, Paris-Saclay University, Paris-Sud University, UVSQ, Villejuif, France. (18) Lille University, Medical School, Lille, France; Medical Oncology, Centre Oscar Lambret, Lille, France. Electronic address: n-penel@o-lambret.fr.

Publication

ESMO Open

Summary

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.

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