title: Cryoablation and resection influences patient survival for soft tissue sarcomas: impact on survivorship and local recurrence.
abstract: Cryosurgical ablation has been used successfully for treating various carcinomas and bone tumors; however, few studies report the use of cryosurgery followed by tumor resection for the treatment of soft tissue sarcomas. We evaluated local recurrence, progression of disease, histologic necrosis from the cryoablation, complications, patient survival, and functional outcomes using this approach. We retrospectively reviewed 38 patients with no prior treatment for their neoplasm who underwent cryosurgery followed by wide excision of soft tissue sarcomas. Three patients developed local recurrence. Sixteen patients had evidence of more than 95% tumor necrosis, and 11 of these had 100% histologic necrosis. We observed a difference in overall survival and disease-free survival based on the adequacy of freezing process. Patients with more than 95% necrosis had a survival rate of 94% at 2 years and 86% at 5 years, while those with less than 95% necrosis survived 53% at 2 years and 34% at 5 years. Complications included transient neuropraxia (13%), superficial wound infections (8%), and seroma (21%). Cryosurgical ablation appears a safe and effective method of devitalizing tumor cells of soft tissue sarcomas.
authors.affiliation: Department of Orthopaedics, Los Angeles County University of Southern California Medical Center, Los Angeles, CA 90033, USA. ahlmann2002@yahoo.com
authors.forename: Elke R
authors.initials: ER
authors.lastname: Ahlmann
authors.forename: Yuri
authors.initials: Y
authors.lastname: Falkinstein
authors.forename: Alexander N
authors.initials: AN
authors.lastname: Fedenko
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: Menendez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003452:Cryosurgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D020127:Recovery of Function; D012189:Retrospective Studies; D012509:Sarcoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome