59 - Safety and Efficacy of Image-Guided Cryoablation in the Treatment of Unresectable Extra-Abdominal Desmoid Tumours

Monday, March 31, 2025

12:10 PM – 1:10 PM CT

Location: Music City Center, Expo Poster Area

Poster Presenter(s)

Varun Yadav, MD, MBBS

Assistant Professor, Intervention Radiology
Homi Bhabha Cancer Hospital and Research Centre, New Chandigarh, India, India

Author/Co-author(s)

NS

Nitin Shetty, MD, MBBS

PROFESSOR
TATA MEMORIAL HOSPITAL, India
Suyash Sureshchandra Kulkarni, MD, MBBS (he/him/his)

PROFESSOR AND HEAD OF DEPARTMENT
TATA MEMORIAL HOSPITAL, India
Kunal Gala, MD, MBBS

Professor
Tata Memorial Hospital, India
MG

Monish G K, MD

Fellow
TMH, India
AR

Akshaykumar Rafaliya, MD

Fellow
TMH, India

Purpose: Desmoid tumours are rare tumours of mesenchymal origin which despite absence of metastasis have high propensity for local invasion leading to severe morbidity. Cryoablation is a minimally invasive modality that can provide relief to symptomatic patients especially in extra-abdominal desmoid tumours. This study is to evaluate efficacy and safety of image-guided cryoablation in extra-abdominal desmoid tumours and to assess the local tumour control, pain control and range of movements in the extremities and complications of the same

Materials and Methods:

Inclusion criteria:

Patient with unresectable extra-abdominal fibromatosis who were symptomatic for the same

Exclusion criteria:

Lesions in close proximity to the neurovascular bundle

Patient unwilling to undergo cryoablation

A total of 20 patients who underwent 27 sessions of cryoablation (4 underwent 2 sessions and 2 underwent 3 sessions) were included in this retrospective study and followed up over 3 months. The following parameters were evaluated prior to cryoablation and at 1 and 3 months post ablation: Visual Analogue Scale (VAS) for pain, Musculoskeletal Tumour Society Scoring System (MSTS) and Tumour volume. RECIST criteria for response asssessment was used for post procedure imaging evaluation and the percentage of necrosis post cryoablation was also noted

Results:

The majority of patient (50%) had received surgery prior to cryoablation with 35% having a prior history of surgery and systemic chemotherapy

Pain was present in all patients and was most commonly seen in combination with restricted movements (40%). The majority of tumours were located in the lower limb (65%)

Mean VAS pre procedure was 5 which decreased to 2.55 and 2.25 on 1 month and 3 month clinical follow up - this was significant with a p-value of < 0.05

The mean MSTS improved from 19.9 to 24 over 3 months which was also significant with a p-value of < 0.05

75% of the tumours showed >50% necrosis following cryoablation with volumes decreasing from 151cm³ to 129.2cm³ at 3 month post ablation follow up

1 patient had transient neuropraxia involving the left lower limb following cryoablation for gluteal fibromatosis which resolved on day 2 with conservative management.

No major complications occurred in any of the patients.

Conclusion: Cryoablation helps in pain palliation and improves functional outcomes in patients with extra-abdominal desmoids. Being a minimally invasive modality, cryoablation can also be repeated in patients with recurrent lesions without the morbidity of surgery or the side effects of chemotherapy given the good safety profile.