A Single Center 10-Year Retrospective Analysis of Cryoablation for the Management of Desmoid Tumors

Summary

Purpose: To retrospectively determine efficacy and safety of cryoablation in patients with desmoid tumors over a 10-year period at a single institution. Materials and methods: Between 25 February 2010 and 25 February 2020, 25 patients (12 - 80 years) with 26 lesions (mean pre-procedural tumor volume was 236.6 cm3) were treated over 44 cryoablation procedures. 11 patients were treated as first line therapy. 14 patients had previous medical therapy, radiotherapy and/or surgery. Subsequent clinical follow up, imaging outcomes and safety were analyzed for technical success, change in total lesion volume (TLV) and viable tumor volume (VTV), modified response evaluation criteria in solid tumors (mRECIST), progression free survival (PFS) for tumor progression and symptom recurrence, symptom improvement and procedure related complications. Symptomatic improvement was defined as documentation of relief of pain (partial or complete) and/or functional impairment. Results: All procedures were technically successful. At 7 to 12 months, median change in TLV and VTV were -6.7% (p = 0.809) and -43.7% (p = 0.01) respectively. By 10-12 months mRECIST, responses were complete response 0%, partial response 61.5% (8/13), stable disease 30.8% (4/13) and progressive disease 7.7% (1/13). Median PFS for tumor progression and symptom recurrence were not reached, with a median follow up of 15.3 months and 21.0 months respectively. Symptomatic relief (partial or complete) was achieved in 96.9% (32/33) of patients. There was 1 major complication (2.4%). Conclusion: In this retrospectively identified cohort, cryoablation is effective and safe for local control of extra-abdominal desmoid tumors in short term follow up.