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经皮冷冻消融治疗腹外硬纤维瘤:10年经验

Percutaneous Cryoablation of Extraabdominal Desmoid Tumors: A 10-Year Experience.

作者信息

Schmitz John J, Schmit Grant D, Atwell Thomas D, Callstrom Matthew R, Kurup Anil N, Weisbrod Adam J, Morris Jonathan M

机构信息

1 Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55902.

出版信息

AJR Am J Roentgenol. 2016 Jul;207(1):190-5. doi: 10.2214/AJR.15.14391. Epub 2016 Apr 11.

Abstract

OBJECTIVE

Extraabdominal desmoid (EAD) tumors pose a therapeutic challenge because they often recur locally and behave aggressively. Accepted management options include surgery, radiation, chemotherapy, and observation. The objective of this study was to assess the safety and efficacy of percutaneous cryoablation for the treatment of EAD tumors.

MATERIALS AND METHODS

A retrospective search of our cryoablation database was performed to identify patients with EAD tumors treated with percutaneous cryoablation between June 15, 2004, and June 15, 2014. During this 10-year time period, we treated 18 patients with 26 discrete tumors during 31 treatment sessions. After cryoablation, contrast-enhanced MRI or CT was performed. Any enhancing soft tissue was considered viable EAD tumor and was measured in three planes.

RESULTS

Of the 26 EAD tumors treated, follow-up imaging with IV contrast material was available for 23 tumors. The mean imaging follow-up was 16.2 ± 20.0 (SD) months. All 31 sessions were technically successful procedures. No residual viable EAD tumor was observed in nine of 23 tumors (39.1%). Some degree of volume reduction was evident in 22 of 23 tumors (95.7%). Progressive disease was observed in one of the 23 tumors (4.3%). Of the cases with residual or progressive disease, the recurrence occurred at the margin of the treated tumor in all cases. No major complications were observed, and none of the complications was more severe than Clavien-Dindo grade I.

CONCLUSION

Percutaneous cryoablation is a safe, effective, and repeatable treatment for achieving local control of EAD tumors.

摘要

目的

腹外硬纤维瘤(EAD)肿瘤带来了治疗挑战,因为它们常常局部复发且具有侵袭性。公认的治疗选择包括手术、放疗、化疗及观察。本研究的目的是评估经皮冷冻消融治疗EAD肿瘤的安全性和有效性。

材料与方法

对我们的冷冻消融数据库进行回顾性检索,以确定2004年6月15日至2014年6月15日期间接受经皮冷冻消融治疗的EAD肿瘤患者。在这10年期间,我们在31次治疗过程中治疗了18例患者的26个离散肿瘤。冷冻消融后,进行了对比增强MRI或CT检查。任何强化的软组织均被视为存活的EAD肿瘤,并在三个平面上进行测量。

结果

在接受治疗的26个EAD肿瘤中,有23个肿瘤可获得静脉造影剂的随访成像。平均成像随访时间为16.2±20.0(标准差)个月。所有31次手术在技术上均获成功。23个肿瘤中有9个(39.1%)未观察到残留的存活EAD肿瘤。23个肿瘤中有22个(95.7%)有一定程度的体积缩小。23个肿瘤中有1个(4.3%)观察到疾病进展。在残留或疾病进展的病例中,所有病例的复发均发生在治疗肿瘤的边缘。未观察到严重并发症,且无一例并发症比Clavien-Dindo I级更严重。

结论

经皮冷冻消融是一种安全、有效且可重复的治疗方法,可实现对EAD肿瘤的局部控制。

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