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Prognostic Factors for Local Recurrence after Cryoablation of Desmoid Tumors
Institution:1. Department of Radiology, Centre Léon Bérard, Lyon, France;2. Department of Medical Oncology, Centre Léon Bérard, Lyon, France;3. Department of Radiation Oncology, Centre Léon Bérard, Lyon, France;4. Department of Surgical Oncology, Centre Léon Bérard, Lyon, France;5. Department of Pediatric Oncology, Centre Léon Bérard, Lyon, France;6. Department of Biostatistics, Centre Léon Bérard, Lyon, France;1. Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, UK;2. Department of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, UK;1. University of Florida, College of Medicine, 1515 SW Archer Rd, Gainesville, FL 32608;2. Department of Anesthesiology, University of Florida, College of Medicine, Gainesville, FL;3. Divisions of Neurosurgical and Vascular Anesthesiology, Department of Anesthesiology, University of Florida, College of Medicine, Gainesville, FL;1. Department of Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center, Tampa, Florida;2. Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida;3. Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, Florida;4. Radiation Oncology, AdventHealth Cancer Institute, Orlando, Florida;5. Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, Florida
Abstract:PurposeTo determine the risk factors for local of adult patients treated for desmoid tumors by cryoablation.Materials and MethodsEighty-four patients treated for nonabdominopelvic desmoid tumors by cryoablation from July 2012 to July 2020 were included in a retrospective study. The population was composed of 64 women (76.19%) and 20 men (23.81%), aged from 16 to 75 years (median, 35 years ± 14.25). Each patient underwent preprocedural gadolinium-enhanced magnetic resonance imaging and was followed up to 36 months with the same technique. Clinical features, such as tumor size and previous treatment, epidemiological features, and the technical parameters of cryoablation, were studied.ResultsLocal relapse was found in 19 (22.62%) of 84 patients. The 12-, 24-, and 36-month progression-free survival rates were 89% (95% confidence interval CI], 79–94), 74% (95% CI, 60–83), and 68% (95% CI, 53–79), respectively. In univariate analysis, significant prognostic factors associated with local recurrence were non–abdominal wall location (P = .042), debulking strategy (P = .0105), risk of visceral injury (P = .034) or peripheral nerve injury during cryoablation (P = .033), previous radiation therapy (P = .043), and treatment before 2016 (P = .008). In multivariate analysis, abdominal wall tumors displayed the best outcome, whereas the neck and trunk showed a high rate of recurrence (hazard ratio, 7.307 95% CI, 1.396–38.261]).ConclusionsThe local recurrence of desmoid tumors after cryoablation depends on a number of prognostic factors, in particular, a non–abdominal wall location of the tumor and previous local treatment such as surgery or radiation therapy.
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