Percutaneous Cryoablation Provides Disease Control for Extra-Abdominal Desmoid-Type Fibromatosis Comparable with Surgical Resection.

Autor: Mandel JE; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA.; Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Kim D; Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Department of Radiology, Weill Cornell Medical College, New York, NY, USA., Yarmohammadi H; Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Department of Radiology, Weill Cornell Medical College, New York, NY, USA., Ziv E; Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Department of Radiology, Weill Cornell Medical College, New York, NY, USA., Keohan ML; Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Department of Medicine, Weill Cornell Medical College, New York, NY, USA., D'Angelo SP; Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Department of Medicine, Weill Cornell Medical College, New York, NY, USA., Gounder MM; Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Department of Medicine, Weill Cornell Medical College, New York, NY, USA., Whiting K; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Qin LX; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Singer S; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Department of Surgery, Weill Cornell Medical College, New York, NY, USA., Crago AM; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Department of Surgery, Weill Cornell Medical College, New York, NY, USA., Erinjeri JP; Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA. erinjerj@mskcc.org.; Department of Radiology, Weill Cornell Medical College, New York, NY, USA. erinjerj@mskcc.org.
Jazyk: angličtina
Zdroj: Annals of surgical oncology [Ann Surg Oncol] 2022 Jan; Vol. 29 (1), pp. 640-648. Date of Electronic Publication: 2021 Jul 16.
DOI: 10.1245/s10434-021-10463-7
Abstrakt: Purpose: The aim of this study was to determine outcomes and prognostic factors for patients with primary and locally recurrent extra-abdominal desmoid tumors who underwent percutaneous cryoablation, and to compare with patients treated with surgery.
Methods: Group characteristics were compared using Fisher's exact test, and propensity score matching was performed using the nearest-neighbor approach. Kaplan-Meier and log-rank analyses were used to evaluate the variation in first local recurrence and disease control, while multivariate Cox regression was used to identify factors associated with first local recurrence. All statistical tests were two-sided and a p-value of 0.05 was considered statistically significant.
Results: Twenty-two cryoablation patients were matched with 33 surgical patients (n = 55). Median follow-up after cryoablation was 16.3 months versus 14.9 months after surgery. Two-year local recurrence-free survival (LRFS) was 59% after cryoablation and 71% after surgery, and median LRFS was 26.6 months after cryoablation but was not reached after surgery. Two-year disease control for all patients was 85%, however median disease control was not reached in either the cryoablation or surgery groups. There was no significant difference in LRFS or disease control between matched cryoablation and surgical patients. No local recurrences occurred after the first cryoablation in patients with zero or one of the following risk factors: tumor size > 5 cm, age ≤ 25 years, or locally recurrent disease. All patients with two or more of these risk factors recurred locally after the first cryoablation.
Conclusion: Percutaneous cryoablation of primary and locally recurrent extra-abdominal desmoid tumors provides freedom from first local recurrence and long-term disease control comparable with surgery.
(© 2021. Society of Surgical Oncology.)
Databáze: MEDLINE
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