Hussein D. Aoun MD, Presenter: Nothing to Disclose

Peter John Littrup MD, Abstract Co-Author: Founder, CryoMedix, LLC Research Grant, Galil Medical Ltd Research Grant, Endo Health Solutions Inc Officer, Delphinus Medical Technologies, Inc

Barbara A. Adam MSN, Abstract Co-Author: Nothing to Disclose

Mohamed M. Jaber MD, Abstract Co-Author: Nothing to Disclose

Brian Faustino Baigorri MD, Abstract Co-Author: Nothing to Disclose

Matthew Prus BS, Abstract Co-Author: Nothing to Disclose

Evan N. Fletcher MS, BA, Abstract Co-Author: Nothing to Disclose

Mark J. Krycia BS, Abstract Co-Author: Nothing to Disclose

To assess the technical feasibility and complication rates of percutaneous pelvic mass cryoablation with respect to tumor size and location. Despite the difficulties of adjacent bowel and lower extremity nerves, we hypothesized that cryoablation could contribute to local tumor control in select patients.

CT and/or CT-US fluoroscopic-guided percutaneous cryoablation was performed in 69 procedures on 82 tumors in 50 patients. Tumor and ablation volumes, location, recurrences, and major complication rates (CTCAE) were collected. Locations were noted as sub-cutaneous, bone, intraperitoneal or retroperitoneal. Patients were excluded if the any bowel appeared adherent or motor nerves couldn’t be avoided by ablation zone. Hydrodissection, balloon displacement of intraperitoneal bowel and urethral warming balloon for a prostate case were used for tissue protection as needed.

All patients required only conscious sedation. Median tumor and ablation diameter was 3.6 cm and 5.6 cm, respectively. Of the 82 of tumors, 35 were in the subcutaneous region, 8 intraperitoneal, 28 retroperitoneal and 11 within bone. There was 1 urachal tumor and 81 metastases which were from sarcoma (16), colorectal (14), ovarian (11), melanoma (9), renal (9) or miscellaneous (22). Of the 69 total procedures, 12 procedures had more than 1 tumor ablated. The low total tumor recurrence rate of 9.8% (8/82) as not significantly affected by tumor size or location with an average followup time of 1.2 yrs. Total major complication rate as low at 5.8% (4/69), despite some tumors initially abutting vital structures that could be adequately protected (ie: sciatic/femoral nerve, urinary bladder and bowel.) Of the complications, 2 were fistulas, 2 were anticipated neurological changes in non-operative patients.

CT guided percutaneous cryoablation of pelvic tumors provides an effective and low morbidity alternative to surgery or radiation, particularly for patients who may require exenteration for local tumor control.

Cryoablation of pelvic tumors has low recurrence and complication rates even for deep locations. Oligometastatic tumor control may avoid morbid pelvic surgeries in selected patients.

Aoun, H, Littrup, P, Adam, B, Jaber, M, Baigorri, B, Prus, M, Fletcher, E, Krycia, M, Cryoablation of Pelvic Masses: A Low Morbidity Alternative in Selected Patients.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14019624.html