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Master Thesis

Cryoablation percutanée des tumeurs desmoides et des sarcomes des tissus mous

Abstract : Background: percutaneous thermal ablations increasingly take part in the treatment strategy of many benign or malignant tumors. For soft-tissue tumors percutaneous cryoablation is the treatment of choice. The aim of our study is to evaluate percutaneous cryoablation in the management of progressive and/or symptomatic extraabdominal desmoid tumor (DT) and locally recurrent or metastatic soft-tissue sarcomas (STS): efficacy and complications. Patients and methods: data of patients treated by percutaneous cryoablation for DT, locally recurrent STS or soft-tissue metastases of STS between 2012 and 2017 at our tertiary referral center were retrospectively collected. Primary endpoint was time-to-next treatment (TNT) for DT and metastatic STS and time-to-local progression (TTLP) for locally recurrent STS. Secondary endpoints were overall survival for STS and complications according to CTCAE v5.0 for DT and STS. Results: forty-nine patients were included, 34 with DT and 15 with STS. A patient treated for a locally recurrent pleomorphic sarcoma of the inferior limb was excluded because lost of follow-up. Overall 75 procedures were performed, 58 for DT and 17 for STS. Median tumor size was 77mm for DT and 43mm for STS. The 1 and 3 year TNT rates for DT were 4% (CI 95% 0-9) and 23% (CI 95% 0-48). Median TNT for metastatic STS was 10.6 months (range 1.7-24.4). The 1 and 2 year TTLP rates for locally recurrent STS were 22% (CI 95% 0-48) and 48% (CI 95% 13-82). The 2 year overall survival rate for STS was 83% (CI 95% 60-100). Complications according to CTCAE v5.0 were grade 2 (n=4), grade 3 (n=1), grade 4 (n=1). Conclusion: percutaneous cryoablation is a safe, effective and minimally-invasive treatment. It allows a prolonged local tumor control in DT. In locally recurrent STS, it allows a salvage treatment with a low morbidity. In selected metastatic STS it delays new line of systemic treatment.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01806285
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Marie-Annaïg Pey. Cryoablation percutanée des tumeurs desmoides et des sarcomes des tissus mous. Médecine humaine et pathologie. 2018. ⟨dumas-01806285⟩

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