Percutaneous Microwave Ablation of Desmoid Fibromatosis

Abstract

Objective To demonstrate the feasibility of percutaneous microwave ablation in desmoid fibromatosis with respect to tumor volume control and improvement in the quality of life. Materials and Methods Twelve microwave ablations were performed in 9 patients with a histological diagnosis of desmoid fibromatosis between January 2010 and January 2019. The study population included 6 female and 3 male, with an age range of 21–76 years (mean = 46.6 years; standard deviation [SD] = 19.3 years). The mean major axis of the tumors was 10.9 cm (SD = 5.2 cm) and mean lesion volume was 212.7 cm 3 (SD = 213 cm 3 ). Their anatomical distribution was as follows: 3 lesions in the thigh, 2 in the gluteus, 2 in the leg and 2 in the periscapular region. We evaluated the reduction in tumor volume and improvement in the quality of life based on the Eastern Cooperative Oncology Group (ECOG) scale. Results An average tumor volume reduction of 70.4% (SD = 24.9) was achieved, while the quality of life (ECOG scale) improved in 88.9% of patients. Conclusion Percutaneous microwave ablation may potentially be a safe, effective, and promising technique for controlling tumor volume and improving the quality of life in patients with desmoid fibromatosis.

Cryotherapy in extra-abdominal desmoid tumors: A systematic review and meta-analysis

“…Image-guided interventional radiologic techniques such as alcohol injection and electroporation [ 14 ], high-intensity focused ultrasound [ 15 , 16 ], and percutaneous microwave and radiofrequency ablation have been used in the treatment of DT [ 17 – 19 ]. Cryoablation has recently been shown in studies to be efficacious and safe [ 20 – 28 ].…”

Economic evaluation of percutaneous cryoablation vs conventional surgery in extra-abdominal desmoid tumours in the Spanish healthcare system

“…Generally, the first therapeutic step consists of watchful waiting strategy or surveillance approach of the tumour; and in case the patient experiences progression or worsening of symptoms, interventional techniques are usually used [ 10 ]. Until recently, surgical resection was the standard of care for these patients [ 6 , 35 ]; however, as part of the evolution of therapy away from primary surgical approaches to less invasive options, image-guided ablation has been accepted as less morbid and includes cryoablation, microwave and high-intensity focused ultrasound ablation [ 16 , 36 ]. These less invasive techniques, such as percutaneous cryoablation, can avoid or reduce the level of morbidity associated to traditional surgery [ 15 ].…”

Clinical trials in desmoid‐type fibromatosis in children and adults: A systematic review

“…Other local therapies like cryoablation (a clinical trial was published after our search), radiofrequency ablation, and high-frequency ultrasound techniques are potential alternatives with good local control outcomes and improved quality of life. [38][39][40] One of the main limitations of this review is the low quality of the included trials. Of the 14 studies, only one was considered as high quality, according to the CONSORT 2010 checklist.…”

“…Because of these potential negative long‐term side effects, radiotherapy is nowadays restricted to highly symptomatic patients for whom no other valuable alternative is available. Other local therapies like cryoablation (a clinical trial was published after our search), radiofrequency ablation, and high‐frequency ultrasound techniques are potential alternatives with good local control outcomes and improved quality of life 38–40 …”