SIR 2024
Interventional Oncology
Ahmed Awad, MBBS
Fellow
The University of Texas Health Science Center at Houston/MD Anderson Cancer Center
Financial relationships: Full list of relationships is listed on the CME information page.
Koustav Pal, MBBS
Postdoctoral Research Fellow
MD Anderson
Financial relationships: Full list of relationships is listed on the CME information page.
Steven Y. Huang, MD, FSIR
Professor
The University of Texas MD Anderson
Disclosure information not submitted.
Steven Yevich, MD MPH
Associate Professor
MD Anderson Cancer Center
Disclosure information not submitted.
Alda Tam, MD, MBA, FSIR
Professor, Department of Interventional Radiology, Division of Diagnostic Imaging
MD Anderson Cancer Center
Financial relationships: Full list of relationships is listed on the CME information page.
Bruno C. Odisio, MD, FSIR (he/him/his)
Interventional Radiologist
MD Anderson Cancer Center
Disclosure information not submitted.
Peiman Habibollahi, MD, RPVI
Assistant Professor
MD Anderson Cancer Center
Financial relationships: Full list of relationships is listed on the CME information page.
Anthony Paul Conley, MD
Associate Professor
MD Anderson Cancer Center
Disclosure information not submitted.
Rahul A. Sheth, MD
Associate Professor
University of Texas MD Anderson Cancer Center
Financial relationships: Full list of relationships is listed on the CME information page.
The purpose of this study was to assess the safety and efficacy of thermal ablation for soft tissue sarcoma metastases (STS) to the liver.
Materials and Methods:
A single-institution retrospective analysis of patients with a histopathological diagnosis of metastatic STS who underwent percutaneous thermal ablation of hepatic metastases between January 2011 and December 2021 was performed. Patients with less than 60 days of follow-up were excluded. The primary outcome was local tumor progression-free survival (LPFS). Secondary outcomes included overall survival (OS), liver-specific progression-free survival, and chemotherapy-free survival (CFS). Complications were categorized based on the Common Terminology Criteria for Adverse Events (CTCAE) classification system.
Results:
55 patients who underwent percutaneous ablation for 84 metastatic liver lesions met eligibility criteria. The most common histopathological subtype of sarcoma in the study group was leiomyosarcoma (LMS, 23/55), followed by gastrointestinal stromal tumor (GIST, 22/55). The median number of treated liver lesions at the time of the procedure was 2 (range: 1 to 8). The median size of treated liver lesions was 1.8 cm (range: 0.3 to 8.7 cm). Complete response at 2 months was achieved in 90% of the treated lesions. LPFS was 83% at 1 year and 80% at 2 years. Liver-specific progression-free survival was 66% at 1 year and 40% at 2 years. The number of progressing lesions at the time of ablation was a significant predictor of LPFS on multivariable Cox proportional hazards modeling (HR 2.98, (95% CI 1.51,5.87), p< 0.002).
OS was 98% at 1 year, 94% at 2 years, and 86% at 3 years. Ablation provided patients with chemotherapy breaks; CFS was 85% at 6 months, and 71% at 12 months. The complication rate was 3.6% (2/55), with 1.8% (1/55) of complications classified as CTCAE grade 3 or higher. On subgroup analysis, 1 year OS and LPFS for GIST and LMS patients were 96% and 93%, and 100% and 89%, respectively.
Conclusion:
Percutaneous thermal liver ablation of soft tissue sarcoma metastases is a safe and effective treatment modality with durable local tumor control that contributes to meaningful chemotherapy breaks.