Percutaneous Image-Guided Cryoablation in Inoperable Extra-abdominal Desmoid Tumors: A Study of Tolerability and Efficacy

Objective

To determine the tolerability, effectiveness and outcomes of percutaneous image-guided cryoablation on inoperable extra-abdominal desmoid tumors.

Methods

Between 2011 and 2012, 13 patients (mean age 39.3 years, range 15–74) with inoperable extra-abdominal desmoid tumors were consecutively treated with cryoablation (17 tumors treated in 17 procedures), including two patients with Gardner syndrome and nine recurrences after surgery. Disease-free survival (DFS) and local control based on RECIST criteria were calculated on prospective clinical and imaging follow-up until 2013.

Results

Cryoablation was performed under ultrasound (n = 8), computed tomography (n = 1), or combined (n = 8) guidance, and under general (n = 15) or local (n = 2) anesthesia. A major complication was observed in one session (5.8 %). Mean follow-up was 11.3 months (6–27 months). Among all the patients treated, eight patients (47 %) presented residual tumors on the first magnetic resonance follow-up, which were asymptomatic. The DFS rate was stable at 82.3 % (95 % confidence interval 0.55–0.94) at 6, 12, and 24 months. The local tumor progression rate was 0 % at 6, 12, and 24 months. Two patients (12 %) presented an in situ recurrence.

Conclusions

Despite high rates of partial ablation, percutaneous image-guided cryoablation appears to be safe and effective for local control for patients with inoperable extra-abdominal desmoid tumors.