1. Time trends in patients with aggressive fibromatosis
Danique L.M. van Broekhoven¹, Dirk J. Grünhagen¹, Michael M.A. den Bakker²,
Thijs van Dalen³, Cornelis Verhoef¹
1. Department of Surgical Oncology, Erasmus MC, Rotterdam, the Netherlands.
2. Department of Pathology, Maasstad ziekenhuis Rotterdam, the Netherlands.
3. Department of Surgery, Diakonessenhuis, Utrecht, the Netherlands.

2. Incidence: 2 - 4 per milion people per year
Current literature
Incidence: per milion people per year
Source: Finnish studies in
Treatment: watchful waiting instead of surgery

3. Study
Aim
Evaluate time trends in incidence and treatment
Method
National pathology registry PALGA
PALGA data: Conclusions and encoding of pathology reports
Query: Extra-abdominal and abdominal wall desmoid tumors

4. Results
1134 patients
Male : Female = 29% : 71%
Median age = 37 years (IQR 30-50)

5. Age OR P Age (years) <20 0,992 0,635 20-44 0,977 0,027 45-64 1,017OR P
Continuous years
Age (years)
<20
0,992
0,635
20-44
0,977
0,027
45-64
1,017
0,173
65-79
1,035
0,069
80+
1,052
0,296

6. Localization OR P Localization Head/Neck 0,981 0,342 Trunk 1,057OR P
Continuous years
Localization
Head/Neck
0,981
0,342
Trunk
1,057
<0,001
Abd. Wall
0,972
0,008
Extremity
0,124
Other
1,012
0,626

7. Diagnosis
OR (95%CI )
P<0.001

8. Treatment
OR (95%CI )
P<0.001

9. Time trends Rising incidence (2.5 fold)
 Different diagnosis or better diagnostic tools?
 True rise: Etiological factors?
Rising incidence
 Observed in all age groups, proportionally highest in older age
 Particularly in trunk desmoids
Work-up and treatment
 Frequency pre-treatment biopsy >>
 Non-surgical treatment >>

10. Time trends Rising incidence (2.5 fold)
 Different diagnosis or better diagnostic tools?
 True rise: Etiological factors?
Rising incidence
 Observed in all age groups, proportionally highest in older age
 Particularly in trunk desmoids
Work-up and treatment
 Frequency pre-treatment biopsy >>
 Non-surgical treatment >>

11. Time trends Rising incidence (2.5 fold)
 Different diagnosis or better diagnostic tools?
 True rise: Etiological factors?
Rising incidence
 Observed in all age groups, proportionally highest in older age
 Particularly in trunk desmoids
Work-up and treatment
 Frequency pre-treatment biopsy >>
 Non-surgical treatment >>

12. Time trends in patients with aggressive fibromatosis
Danique L.M. van Broekhoven¹, Dirk J. Grünhagen¹, Michael M.A. den Bakker²,
Thijs van Dalen³, Cornelis Verhoef¹
1. Department of Surgical Oncology, Erasmus MC, Rotterdam, the Netherlands.
2. Department of Pathology, Maasstad ziekenhuis Rotterdam, the Netherlands.
3. Department of Surgery, Diakonessenhuis, Utrecht, the Netherlands.

13. Etiological factor: Surgery

14. Etiological factor: Hormones