Percutaneous cryoablation for the treatment of extra-abdominal desmoid tumors. J Surg Oncol 2019 Sep;120(3):366-375
Date
06/27/2019Pubmed ID
31236956Pubmed Central ID
PMC6790665DOI
10.1002/jso.25597Scopus ID
2-s2.0-85070848395 (requires institutional sign-in at Scopus site) 46 CitationsAbstract
BACKGROUND: Desmoid tumors are rare locally invasive, benign neoplasms that develop along aponeurotic structures. Current treatment is complicated by associated morbidity and high recurrence rates.
METHODS: A retrospective, single-institution review identified 23 patients (age: 16-77) with extra-abdominal desmoid tumors who received CT-guided percutaneous cryoablation as either a first-line (61%) or salvage (39%) treatment in 30 sessions between 2014 and 2018. Median maximal lesion diameter was 69 mm (range: 11-209). Intent was curative in 52% and palliative in 48%. Contrast-enhanced cross-sectional imaging was obtained before and after treatment in addition to routine clinical follow-up.
RESULTS: Technical success was achieved in all patients. The median follow-up was 15.4 months (3.5-43.4). Symptomatic improvement was demonstrated in 89% of patients. At 12 months, the average change in viable volume was  -80% (range -100% to  + 10%) and response by modified response evaluation criteria in solid tumors (mRECIST) was CR 36%, PR 36%, and SD 28% No rapid postablation growth or track seeding was observed. Four patients underwent repeat cryoablation for either residual or recurrent disease. Two patients sustained a major procedural complication consisting of significant neuropraxia.
CONCLUSION: Cryoablation for desmoid tumors demonstrates a high degree of symptom improvement and local tumor control on early follow-up imaging with relatively low morbidity.
Author List
Redifer Tremblay K, Lea WB, Neilson JC, King DM, Tutton SMAuthors
David M. King MD Chair, Professor in the Orthopaedic Surgery department at Medical College of WisconsinJohn C. Neilson MD Associate Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Abdominal WallAdolescent
Adult
Aged
Cryosurgery
Extremities
Female
Fibromatosis, Aggressive
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Retrospective Studies
Thoracic Wall
Tomography, X-Ray Computed
Young Adult
