Local Control and Analgesic Efficacy of Percutaneous Cryoablation for Desmoid Tumors

Cardiovasc Intervent Radiol. 2020 Jan;43(1):110-119. doi: 10.1007/s00270-019-02323-5. Epub 2019 Aug 30.

Abstract

Objective: Cryoablation is being more and more often used to treat desmoid tumors. We report our experience of cryoablation as a local and analgesic treatment for inoperable or recurring desmoid tumors.

Methods: This study includes 34 patients who underwent percutaneous cryoablation of 41 desmoid tumors between July 2012 and September 2016. All patients underwent pain assessment using a visual analog scale (VAS) and preoperative imaging. All cryoablation procedures were performed using the same cryoablation system. Patients received clinical and radiological follow-up at 6 months post-procedure, with pain-rating and adverse events being recorded. A long-term follow-up was achieved until 31 December 2018. Disease-free survival at 3 years was also recorded. Radiological tumor response was determined by tumor measurements using RECIST 1.1.

Results: Twelve patients benefitted from curative treatment on 100% of the tumor volume, but 22 patients received debulking treatment because of the risk of neighboring structures. Two patients had a postoperative hematoma grade 2 of the CIRSE classification system for complications, and two patients had grade 4 complications involving palsy of the common fibular nerve. Disease-free survival at 3 years was 42.2%. The mean VAS pain scores were 5.7 and 2.4 at pretreatment and 6 months, respectively, showing a mean reduction of 3.3 (p < 0.001). At 6 months, all measured tumor dimensions were significantly lower than pretreatment.

Conclusion: Cryoablation is an effective therapeutic option for the local treatment and for the analgesic management of desmoid tumors.

Keywords: Ablation techniques; Cryoablation; Desmoid tumors; Pain.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Analgesia / methods*
  • Cohort Studies
  • Cryosurgery / methods*
  • Desmoid Tumors / complications*
  • Desmoid Tumors / surgery*
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Pain / etiology*
  • Pain / surgery*
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult