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)

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Summary

Introduction

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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