Percutaneous computed tomography-guided cryoablation for recurrent retroperitoneal soft tissue sarcoma: a study of safety and efficacy

// Wenzhe Fan 1 , Lizhi Niu 2, 3 , Yu Wang 1 , Yingqiang Zhang 1 , Xuehua Yao 1 , Guosheng Tan 4 , Jianyong Yang 4, 5 , Jiaping Li 1 1 Department of Interventional Oncology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China 2 Fuda Cancer Hospital, Guangzhou, China 3 Fuda Institute of Cryosurgery for Cancer, Guangzhou, China 4 Department of Interventional Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China 5 Department of Medical Imaging, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China Correspondence to: Jia-Ping Li, email: lijiaping_2011@126.com Keywords: computer tomography, cryoablation, retroperitoneal sarcoma, survival, response rate Received: October 10, 2015     Accepted: April 16, 2016     Published: May 19, 2016 ABSTRACT Aims: To evaluate the use of computed tomography image-guided percutaneous cryoablation for recurrent retroperitoneal soft tissue sarcomas (RPSs). Results: Adverse events were limited to grades 1 and 2, included fever (n = 19), local pain (n = 11), emesis (n = 10), frostbite (n = 6), and nerve injury (n = 1). Fever was more frequent in the large tumor group (15.8%) than in small tumor group (1.9%) ( P = 0.008). Median PFS and OS were 37.0 ± 7.7 months (range, 4–39 months) and 43.0 ± 5.9 months (range, 6–54 months), respectively. PFS and OS were significantly longer in the small tumor group than in the large tumor group ( P = 0.011 and P = 0.015, respectively), but the response rate (82.7% vs. 72.8%, P = 0.240) did not differ significantly. On univariate analysis, tumor size, tumor invasion grade, and distant metastasis were significant prognostic factors for PFS and OS. On multivariate analysis, a tumor size ≥10 cm was an independent negative prognostic factor for PFS and OS after cryoablation (HR: 3.98, 95% CI: 1.27–12.50, P = 0.018 and HR: 4.33, 95% CI: 1.41–13.26, P = 0.010, respectively). Materials and Methods: Data from 72 patients with recurrent RPSs who underwent percutaneous cryoablation were reviewed retrospectively. The prognostic factors for progression-free survival (PFS), overall survival (OS), and efficacy based on mRECIST criteria were analysis. Adverse events were compared according to tumor size (<10 and ≥10 cm). Conclusion: Minimally invasive percutaneous cryoablation was safe and efficacious for recurrent RPSs.