Cryo-surgery for symptomatic extra-abdominal desmoids. A proof of concept study

Ben Efrima*, Joshua Ovadia, Ido Drukman, Amal Khoury, Ehud Rath, Solomon Dadia, Yair Gortzak, Assaf Albagli, Amir Sternheim, Ortal Segal

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background and Objective: Extra abdominal desmoid tumors are rare, highly aggressive, and invasive benign soft tissue tumors. Current treatment modalities show high levels of recurrence and comorbidities. Cryo-surgery as an alternative was subsequently investigated. Methods: In this retrospective, single center study 11 patients showing symptomatic tumors were treated with individualized cryo-surgery. Treatment protocol included preoperative planning using computer rendered 3D models, intraoperative navigation and execution using cone beam guidance, and postoperative magnetic resonance imaging image analysis using a gaussian mixture model software. Subjective outcomes were reported using Short Form Health Survey (SF-36) questionnaires. Results: Sixteen ablations were performed, each demonstrating a complete match with the determined preoperative plan and model. A total of 9/11 (82%) of patients showed improvements in symptoms and a reduction in tumor volume while 2/11 (18%) did not. Average reduction in tumor volume and viable segments were 36.7% (p = 0.0397) and 63.3% (p = 0.0477), respectively. Mild complications according to the SIR Adverse Event Classification Guidelines were experienced in 3/16 (19%) ablations. SF-36 scores showed a statistically significant improvement (p = 0.0194) in the mental health category and a nonsignificant (p = 0.8071) improvement in the physical health category. Conclusion: Cryo-surgery using the three-phase protocol as described may improve the overall outcome of future ablation procedures.

Original languageEnglish
Pages (from-to)627-634
Number of pages8
JournalJournal of Surgical Oncology
Volume124
Issue number4
DOIs
StatePublished - 15 Sep 2021

Keywords

  • 3D modeling
  • Cryo-surgery
  • cone beam navigation
  • extra-abdominal desmoid tumor
  • gaussian mixture model

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