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Extra-abdominal desmoid fibromatosis: Cryoablation versus traditional therapies

      Highlights

      • Patients who underwent surgery or cryoablation were the most likely to demonstrate a reduction in EDF lesion size.
      • Complication rates were lowest in patients who underwent cryoablation.
      • EDF lesions of the back and thorax demonstrated the highest response to treatment overall.

      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.

      Keywords

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