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Master Thesis

Effet antalgique de la cryothérapie percutanée dans les tumeurs desmoïdes extra-abdominales

Abstract : Background and aim of the work: Desmoid tumours are rare benign tumours that can be locally very aggressive and can cause disabling symptoms such as limb deformity and severe pain. We report on our experience of cryotherapy as a local analgesic treatment for inoperable or recurring desmoids tumours. Methods: This study includes 34 patients who underwent percutaneous cryoablation of desmoids tumours between July 2012 and September 2016. All patients underwent pain assessment using a visual analogue scale (VAS) and preoperative imaging. All cryoablation procedures were performed using the same cryotherapy system. Patients received clinical and radiological follow-up at 3 and 6 months post-procedure, with pain-rating and undesirable events being recorded. Radiological tumour response was determined by tumour measurements. Results: Twelve patients benefitted from curative treatment on 100% of the tumour volume, but 29 patients received partial treatment because of the risk to neighbouring structures. Fourteen complications of grade I on the Clavien-Dindo classification were recorded, and two patients presented with grade II complications involving palsy of the peroneal nerve. On a per-patient basis, the mean VAS pain scores were 5.7 and 2.4 at pre-treatment and 6 months respectively, showing a mean reduction of 3.3 (p<0.05). At 6 months, all measured tumour dimensions were significantly lower than pre-treatment. Conclusions: Cryotherapy is an effective therapeutic option for the analgesic management of desmoids tumours. The analgesic efficacy did not correlate with a reduction in tumour volume, but did appear to be related to the volume of tumour necrosis induced by cryotherapy.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02263099
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Fabrice Lame. Effet antalgique de la cryothérapie percutanée dans les tumeurs desmoïdes extra-abdominales. Imagerie. 2018. ⟨dumas-02263099⟩

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