Determinants of morbidity and local control after cryoablation of sporadic extra-abdominal desmoid tumors.
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AIMS: To identify factors associated with morbidity and local progression-free survival (LPFS) following percutaneous cryoablation (CA) of sporadic extra-abdominal desmoid tumors (EADT). METHODS: All patients undergoing CA for EADT between 2009 and 2024 were included in this retrospective study. Disease progression was evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST); morbidity using the Common Terminology Criteria for Adverse Events (CTCAE). Logistic regression analyses were performed to assess associations between patient characteristics, tumor features, procedural parameters, and outcomes related to morbidity and LPFS. RESULTS: Morbidity analysis included 75 patients. CTCAE grade 1-2 and grade 3-4 events occurred in 38/75 (50.7%) and 8 patients (10.7%), respectively. Oncological outcomes data were available in 64 patients. After a median follow-up of 27.5 months (interquartile range, 13.75-52), disease remained non-progressive in 31 patients (31/64; 48%). Estimated 1-, 3-, and 5-year LPFS rates were 59.6% (95% confidence intervals-CI: 48.2-73.6), 45.6% (95%CI: 33.7-61.7), and 38.5% (95%CI: 26.2-56.5), respectively. Symptom relapse occurred in 27 (27/64; 42.2%) patients, of whom 22 (22/64; 34.4%) showed disease progression. Tyrosine kinase inhibitors (TKIs) were associated with higher morbidity (OR = 53.8; 95%CI: 5.2-2116.1; P < 0.05); complete tumor coverage by the iceball with longer LPFS (OR = 7.14; 95% CI: 1.56-43.2; P < 0.05), symptom recurrence with shorter LPFS (OR = 0.09; 95% CI: 0.02-0.3; P < 0.05). CONCLUSIONS: In patients with sporadic EADT treated with CA, prior TKIs are associated with increased morbidity. Complete tumor coverage by the iceball predicts prolonged LPFS, whereas symptom recurrence predicts disease progression.