Percutaneous cryoablation: a novel treatment option in non-visceral metastases of the abdominal cavity after prior surgery

Abdom Radiol (NY). 2022 Sep;47(9):3345-3352. doi: 10.1007/s00261-022-03598-y. Epub 2022 Jul 2.

Abstract

Purpose: To assess the primary safety and oncological outcome of percutaneous cryoablation in patients with non-visceral metastases of the abdominal cavity after prior surgery.

Methods: All patients with non-visceral metastases after prior abdominal surgery, treated with percutaneous cryoablation, and at least one year of follow-up were retrospectively identified. Technical success was achieved if the ice-ball had a minimum margin of 10 mm in three dimensions on the per-procedural CT images. Complications were recorded using the Society of Interventional Radiology (SIR) classification system. Time until disease progression was monitored with follow-up CT and/or MRI. Local control was defined as absence of recurrence at the site of ablation.

Results: Eleven patients underwent cryoablation for 14 non-visceral metastases (mean diameter 20 ± 9 mm). Primary tumor origin was renal cell (n = 4), colorectal (n = 3), granulosa cell (n = 2), endometrium (n = 1) and appendix (n = 1) carcinoma. Treated metastases were localized retroperitoneal (n = 8), intraperitoneal (n = 2), or in the abdominal wall (n = 4). Technical success was achieved in all procedures. After a median follow-up of 27 months (12-38 months), all patients were alive. Local control was observed in 10/14 non-visceral metastases, and the earliest local progression was detected after ten months. No major adverse events occurred. One patient suffered a minor asymptomatic adverse event.

Conclusion: This proof-of-concept study suggests that cryoablation can be a minimal invasive treatment option in a selected group of patients with non-visceral metastases in the abdominal cavity after prior surgery.

Keywords: Abdomen; Cryosurgery; Interventional Radiology; Metastases; Neoplasms.

MeSH terms

  • Abdominal Cavity* / pathology
  • Cryosurgery* / methods
  • Female
  • Humans
  • Kidney Neoplasms* / pathology
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Treatment Outcome