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腹外型硬纤维瘤病:冷冻消融与传统疗法的对比。

Extra-abdominal desmoid fibromatosis: Cryoablation versus traditional therapies.

机构信息

Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA.

United Imaging Consultants, 5800 Foxridge Dr, Suite 240, Mission, KS 66202, USA.

出版信息

Clin Imaging. 2022 Aug;88:9-16. doi: 10.1016/j.clinimag.2022.05.001. Epub 2022 May 5.

Abstract

PURPOSE

To retrospectively review the various methods used to treat extra-abdominal desmoid fibromatosis (EDF) at our institution to compare treatment response and complications with those for the emerging option of percutaneous cryoablation therapy.

METHODS

A single-center retrospective review was conducted to identify patients with EDF who underwent some form of treatment for EDF in any combination (including medical therapy, surgery, percutaneous ablation and radiation therapy) at our institution between January 2007 and January 2020. Patients with pathological evidence of EDF and pretreatment and posttreatment images were included. Medical records and imaging data were also reviewed. Treatment response assessment was based on tumor size on follow-up imaging.

RESULTS

A total of 41 patients (30 women; mean age, 34 y; range, 18-79 y) were included in the study. The extremities (44%) and back (22%) were the most common locations of EDF. Patients underwent a variety of treatment methods, including medical therapy (31 patients), surgery (24 patients), cryoablation (7 patients), radiation therapy (6 patients), and radiofrequency ablation (4 patients). Reduction in lesion size after at least 3 months of follow-up was most common in patients who underwent surgery alone (5 patients) or cryoablation (4 patients). Among all study patients, there were 10 minor complications and 3 major complications. Complication rates were lowest in patients who underwent cryoablation (no complications).

CONCLUSION

Although further work is needed, the early data in this study offers promising results regarding the clinical application of cryoablation for EDF, which appears safer than radiofrequency ablation and a potentially effective.

摘要

目的

回顾本机构治疗腹外型纤维瘤病(EDF)的各种方法,以比较治疗反应和并发症与新兴的经皮冷冻消融治疗的结果。

方法

对本机构 2007 年 1 月至 2020 年 1 月间接受过任何形式 EDF 治疗(包括药物治疗、手术、经皮消融和放射治疗)的 EDF 患者进行单中心回顾性研究。纳入有 EDF 病理证据且有治疗前后影像学资料的患者。还回顾了病历和影像学资料。治疗反应评估基于随访影像学上的肿瘤大小。

结果

共纳入 41 例患者(30 例女性;平均年龄 34 岁;范围 18-79 岁)。EDF 最常见的部位是四肢(44%)和背部(22%)。患者接受了多种治疗方法,包括药物治疗(31 例)、手术(24 例)、冷冻消融(7 例)、放射治疗(6 例)和射频消融(4 例)。至少随访 3 个月后,仅手术(5 例)或冷冻消融(4 例)患者的病变大小缩小。所有研究患者中,有 10 例轻微并发症和 3 例严重并发症。冷冻消融患者的并发症发生率最低(无并发症)。

结论

尽管还需要进一步的研究,但本研究的早期数据提供了冷冻消融治疗 EDF 的临床应用的有前景的结果,与射频消融相比,冷冻消融似乎更安全,且可能更有效。

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