Abstract
AimsTo evaluate the use of computed tomography image-guided percutaneous cryoablation for recurrent retroperitoneal soft tissue sarcomas (RPSs).ResultsAdverse events were limited to grades 1 and 2, included fever (n = 19), local pain (n = 11), emesis (n = 10), frostbite (n = 6), and nerve injury (n = 1). Fever was more frequent in the large tumor group (15.8%) than in small tumor group (1.9%) (P = 0.008). Median PFS and OS were 37.0 ± 7.7 months (range, 4–39 months) and 43.0 ± 5.9 months (range, 6–54 months), respectively. PFS and OS were significantly longer in the small tumor group than in the large tumor group (P = 0.011 and P = 0.015, respectively), but the response rate (82.7% vs. 72.8%, P = 0.240) did not differ significantly. On univariate analysis, tumor size, tumor invasion grade, and distant metastasis were significant prognostic factors for PFS and OS. On multivariate analysis, a tumor size ≥10 cm was an independent negative prognostic factor for PFS and OS after cryoablation (HR: 3.98, 95% CI: 1.27–12.50, P = 0.018 and HR: 4.33, 95% CI: 1.41–13.26, P = 0.010, respectively).Materials and MethodsData from 72 patients with recurrent RPSs who underwent percutaneous cryoablation were reviewed retrospectively. The prognostic factors for progression-free survival (PFS), overall survival (OS), and efficacy based on mRECIST criteria were analysis. Adverse events were compared according to tumor size (<10 and ≥10 cm).ConclusionMinimally invasive percutaneous cryoablation was safe and efficacious for recurrent RPSs.
Highlights
Retroperitoneal soft tissue sarcomas (RPSs) are neoplasms that originate in the retroperitoneum but not in the major retroperitoneal organs themselves
progression-free survival (PFS) and overall survival (OS) were significantly longer in the small tumor group than in the large tumor group (P = 0.011 and P = 0.015, respectively), but the response rate (82.7% vs. 72.8%, P = 0.240) did not differ significantly
A tumor size ≥10 cm was an independent negative prognostic factor for PFS and OS after cryoablation (HR: 3.98, 95% CI: 1.27–12.50, P = 0.018 and HR: 4.33, 95% CI: 1.41–13.26, P = 0.010, respectively)
Summary
Retroperitoneal soft tissue sarcomas (RPSs) are neoplasms that originate in the retroperitoneum but not in the major retroperitoneal organs themselves. They account for approximately 0.15% of all malignancies [1]. These tumors are difficult to manage because of their proximity to vital structures in the abdominal cavity and adjacent compartments [2]. Challenges associated with RPS resection may affect survival and lead to local recurrence. Tumor re-excision is recommended in case of RPS recurrence; repeat resection is even more challenging, and whether adjuvant chemotherapy and radiotherapy offer additional benefits is controversial [5]
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