1. Association between recent pregnancy or hormonal contraceptive exposure and outcome of desmoid-type fibromatosis
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M. Debaudringhien, J.-Y. Blay, A.-M. Bimbai, S. Bonvalot, A. Italiano, C. Rousset-Jablonski, N. Corradini, S. Piperno-Neumann, C. Chevreau, J.-E. Kurtz, C. Guillemet, E. Bompas, O. Collard, S. Salas, A. Le Cesne, D. Orbach, J. Thery, M.-C. Le Deley, O. Mir, N. Penel, Université de Lille, Centre Léon Bérard [Lyon], Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université de Lille-UNICANCER, Institut Curie [Paris], Institut Bergonié [Bordeaux], UNICANCER, Institut Claudius Regaud, CHU Strasbourg, Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), Institut de Cancérologie de la Loire Lucien Neuwirth, Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Hôpital de la Timone [CHU - APHM] (TIMONE), Institut Gustave Roussy (IGR), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Institut National de la Santé et de la Recherche Médicale, Inserm, Ligue Contre le Cancer: PRE2016.LCC/NP, Companhia Energética de São Paulo, CESP, Institut National Du Cancer, INCa, The authors would like to thank the patients and families for their participation in this study, the staff members involved in study management, in particular Emilie Decoupigny and Marie Vanseymortier from the sponsorship unit at Centre Oscar Lambret (Lille University), all investigators and their teams who participated in the study, the patient advocacy group ‘SOS Desmoïde’, Guillemette Antoni, a biostatistician from CESP (INSERM Villejuif), for her advice, Françoise Bonichon for her help in the literature research, and the data-managers from Centre de Traitement des Données du Cancéropôle Nord-Ouest (CTD-CNO), who oversaw the study data management, the CTD-CNO clinical research platform was funded by the French National Cancer Institute (INCa) and ‘La Ligue Nationale Contre le Cancer’., This work was supported by a personal grant from a donor (S. Wisnia), the Ligue Nationale Contre le Cancer (PRE2016.LCC/NP), Intersarc (funded by the French National Cancer Institute , INCA ), and SOS Desmoïde (no grant number). These funders had no role in the design, conduct, or reporting of this work., HAL UVSQ, Équipe, and Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)
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Adult ,Cancer Research ,hormone-dependency tumor ,hormonal contraception ,desmoid-type fibromatosis ,Estrogens ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Fibromatosis, Aggressive ,Contraceptive Agents ,[SDV.CAN] Life Sciences [q-bio]/Cancer ,Oncology ,outcome ,Humans ,Female ,Prospective Studies ,pregnancy ,Progestins ,Neoplasm Recurrence, Local - Abstract
International audience; 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.
- Published
- 2022
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