title: Time trends in the incidence and treatment of extra-abdominal and abdominal aggressive fibromatosis: a population-based study.
abstract: BACKGROUND
  Aggressive fibromatosis (AF) is a locally infiltrating soft-tissue tumor. In a population-based study in the Netherlands, we evaluated time trends for the incidence and treatment of AF.
  
  
  METHODS
  In PALGA: Dutch Pathology Registry, all patients diagnosed between 1993 and 2013 as having extra-abdominal or abdominal wall aggressive fibromatosis were identified and available pathology data of the patients were evaluated. Epidemiological and treatment-related factors were analyzed with χ (2)and regression analysis.
  
  
  RESULTS
  During the study period, 1134 patients were identified. The incidence increased from 2.10 to 5.36 per million people per year. Median age at the time of diagnosis increased annually by B 0.285 (P = 0.001). Female gender prevailed and increased over time [annual odds ratio (OR) 1.022; P = 0.058]. All anatomic localizations, but in particular truncal tumors, became more frequent. During the study period diagnostic histological biopsies were performed more often (annual OR 1.096; P < 0.001). The proportion of patients who underwent surgical treatment decreased (annual OR 0.928; P < 0.001). When resection was preceded by biopsy, 49.8 % of the patients had R0-resection versus 30.7 % in patients without biopsy (P < 0.001).
  
  
  CONCLUSIONS
  In this population-based study, an increasing incidence of extra-abdominal and abdominal-wall aggressive fibromatosis was observed. The workup of patients improved and a trend towards a nonsurgical treatment policy was observed.
authors.affiliation: Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands, d.vanbroekhoven@erasmusmc.nl.
authors.forename: Danique L M
authors.initials: DL
authors.lastname: van Broekhoven
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Grünhagen
authors.forename: Michael A
authors.initials: MA
authors.lastname: den Bakker
authors.forename: Thijs
authors.initials: T
authors.lastname: van Dalen
authors.forename: Cornelis
authors.initials: C
authors.lastname: Verhoef
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D018221:Fibromatosis, Abdominal / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*; D018222:Desmoid Tumors / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D013997:Time Factors; D055815:Young Adult