03:45 PM Abstract No. 301 Percutaneous cryoablation for the treatment of extra-abdominal desmoid tumors

Abstract

Desmoid tumors are a rare form of locally invasive, benign neoplasms that develop along aponeurotic structures with high recurrence rate after surgical resection. The purpose of this study was to evaluate the safety and efficacy of cryoablation for local disease control. A retrospective search of our single-institution database identified 23 patients with extra-abdominal desmoid tumors who were treated with percutaneous cryoablation as both de novo (61% pts) and salvage (39% pts) treatment in 28 sessions between 2014 and 2018. Mean lesion diameter was 7.0 cm, ranging from 1.1 - 14.0 cm. 48% of patients were treated with the goal of complete ablation, while 52% were treated for palliative debulking. Patient age ranged from 16 to 77 years. Tumors were treated in the abdominal wall, chest wall, shoulder girdle, upper extremity, hip girdle, lower extremity, and head and neck. Imaging was evaluated for baseline tumor size, MR characteristics, and enhancing tumor volume. Technical success was achieved in 100% of patients. 90% of patients who were symptomatic on presentation showed clinical improvement following ablation. One patient suffered a major procedural complication consisting of significant neuropraxia. The average imaging follow-up was 14.6 months (SD ± 10.9). Of 11 patients with follow-up imaging at 12 months, the enhancing tumor volume showed either complete response (CR) or partial response (PR) in all patients (CR 27%, PR 73%), and the total lesion volume showed either CR or PR in 9 of 11 patients. No treatments demonstrated rapid post-ablation growth or track seeding. Three patients underwent repeat cryoablation for either residual or progressive disease. Cryoablation for desmoid tumors demonstrates a high degree of symptom improvement and local tumor control on early follow-up imaging with relatively few side effects. Study limitations include variable follow-up, small sample size, and the retrospective nature of this case series; however, further studies should be pursued as these data provide promising results.