Annals of Surgery

Skip Navigation LinksHome > May 2014 - Volume 259 - Issue 5 > Desmoid-Type Fibromatosis and Pregnancy: A Multi-institution...
Annals of Surgery:
doi: 10.1097/SLA.0000000000000224
Original Articles

Desmoid-Type Fibromatosis and Pregnancy: A Multi-institutional Analysis of Recurrence and Obstetric Risk

Fiore, Marco MD*; Coppola, Sara MD; Cannell, Amanda J. BScH; Colombo, Chiara MD*; Bertagnolli, Monica M. MD§; George, Suzanne MD; Le Cesne, Axel MD; Gladdy, Rebecca A. MD, PhD; Casali, Paolo G. MD**; Swallow, Carol J. MD, PhD; Gronchi, Alessandro MD*; Bonvalot, Sylvie MD; Raut, Chandrajit P. MD, MSc§

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Abstract

Background: Many women who present with desmoid-type fibromatosis (DF) have had a recent pregnancy. Long-term data about disease behavior during and after pregnancy are lacking.

Objective: To investigate the possible relationship between DF and pregnancy.

Patients and Methods: A cohort of women with DF and pregnancy was identified from 4 sarcoma centers. Four groups were identified: diagnosis during pregnancy (A); diagnosis after delivery (B); DF clinically evident during pregnancy (C); and DF resected before pregnancy (D). Progression/regression rates, recurrence rates after resection, and obstetric outcomes were analyzed.

Results: Ninety-two women were included. Forty-four women (48%) had pregnancy-related DF (A + B), whereas 48 (52%) had a history of DF before conception (C + D). Initial treatment was resection in 52%, medical therapy in 4%, and watchful waiting in 43%. Postsurgical relapse rate in A + B was 13%, although progression during watchful waiting was 63%. Relapse/progression in C + D was 42%. After pregnancy, 46% underwent treatment of DF, whereas 54% were managed with watchful waiting. Eventually, only 17% experienced further progression after treatment. Spontaneous regression occurred in 14%. After further pregnancies, only 27% progressed. The only related obstetric event was a cesarean delivery.

Conclusions: Pregnancy-related DF has good outcomes. Progression risk during pregnancy is high, but it can be safely managed. DF does not increase obstetric risk, and it should not be a contraindication to future pregnancy.

© 2014 by Lippincott Williams & Wilkins.

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