Safety and efficacy of percutaneous image-guided ablation for soft tissue sarcoma metastases to the liver

Cancer. 2024 Aug 1;130(15):2703-2712. doi: 10.1002/cncr.35330. Epub 2024 Apr 20.

Abstract

Purpose: To evaluate outcomes following percutaneous image-guided ablation of soft tissue sarcoma metastases to the liver.

Materials and methods: A single-institution retrospective analysis of patients with a diagnosis of metastatic soft tissue sarcoma who underwent percutaneous image-guided ablation of hepatic metastases between January 2011 and December 2021 was performed. Patients with less than 60 days of follow-up after ablation were excluded. The primary outcome was local tumor progression-free survival (LPFS). Secondary outcomes included overall survival, liver-specific progression-free survival. and chemotherapy-free survival.

Results: Fifty-five patients who underwent percutaneous ablation for 84 metastatic liver lesions were included. The most common histopathological subtypes were leiomyosarcoma (23/55), followed by gastrointestinal stromal tumor (22/55). The median treated liver lesions was 2 (range, 1-8), whereas the median size of metastases were 1.8 cm (0.3-8.7 cm). Complete response at 2 months was achieved in 90.5% of the treated lesions. LPFS was 83% at 1 year and 80% at 2 years. Liver-specific progression-free survival was 66% at 1 year and 40% at 2 years. The overall survival at 1 and 2 years was 98% and 94%. The chemotherapy-free holiday from the start of ablation was 71.2% at 12 months. The complication rate was 3.6% (2/55); one of the complications was Common Terminology Criteria for Adverse Events grade 3 or higher. LPFS subgroup analysis for leiomyosarcoma versus gastrointestinal stromal tumor suggests histology-agnostic outcomes (2 years, 89% vs 82%, p = .35).

Conclusion: Percutaneous image-guided liver ablation of soft tissue sarcoma metastases is safe and efficacious.

Keywords: ablation technique; hepatic; interventional radiology; metastases; soft tissue sarcoma; survival.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Catheter Ablation / adverse effects
  • Catheter Ablation / methods
  • Female
  • Gastrointestinal Stromal Tumors / mortality
  • Gastrointestinal Stromal Tumors / pathology
  • Gastrointestinal Stromal Tumors / surgery
  • Humans
  • Leiomyosarcoma / mortality
  • Leiomyosarcoma / pathology
  • Leiomyosarcoma / secondary
  • Leiomyosarcoma / surgery
  • Liver Neoplasms* / secondary
  • Liver Neoplasms* / surgery
  • Male
  • Middle Aged
  • Progression-Free Survival
  • Retrospective Studies
  • Sarcoma* / mortality
  • Sarcoma* / pathology
  • Sarcoma* / secondary
  • Sarcoma* / surgery
  • Treatment Outcome