title: Standardization of selection criteria for percutaneous image-guided cryoablation of recurrent soft-tissue sarcomas.
abstract: OBJECTIVE
  Percutaneous image-guided cryoablation has not been validated for local management of recurrence of soft tissue sarcoma (STS) of the trunk or limbs. This study aims to identify selection criteria for cryoablation in order to standardize indications of this treatment.
  
  
  METHODS
  Between 2000 and 2010, 46 patients (57 tumors) presenting local recurrences of STS of the trunk or limbs and treated following standards of care were selected from our institutional database. Eligibility for cryoablation was assessed by two radiologists according to predefined criteria: maximal diameter size of the tumor ≤10cm, distance to skin >5mm, distance to neurovascular structures 3mm at least, absence of articular involvement and planned cryoablation covering the entire lesion volume. Characteristics and outcomes were compared.
  
  
  RESULTS
  There was nearly perfect agreement for all criteria (k coefficient ranging from 0.83 to 0.98) between both readers. A subgroup of 13patients was identified as eligible for cryoablation. Locations to the trunk, pelvic girdle or shoulder were significantly more present in the cryoablation group (P=0.002). In this group, tumors were mainly located deeply (P=0.002) with great axes ≤5cm (P=0.044). High local tumor aggressiveness (P=0.016) and differentiated myxoid liposarcoma or myxofibrosarcoma (P=0.007) were more frequent in the eligible group.
  
  
  CONCLUSIONS
  Based on these criteria, two groups of patients with local relapse of STS can be identified. These results may improve the standardization of selection of patients who could be candidates for cryoablation.
authors.affiliation: Department of Radiology, Institute Bergonié, 229, cours de l'Argonne, 33076 Bordeaux, France.
authors.forename: N
authors.initials: N
authors.lastname: Lippa
authors.affiliation: Department of Radiotherapy, Institute Bergonié, 229, cours de l'Argonne, 33076 Bordeaux, France.
authors.forename: P
authors.initials: P
authors.lastname: Sargos
authors.affiliation: Department of Medical Oncology, Institute Bergonié, 229, cours de l'Argonne, 33076 Bordeaux, France.
authors.forename: A
authors.initials: A
authors.lastname: Italiano
authors.affiliation: Department of Radiology, Institute Bergonié, 229, cours de l'Argonne, 33076 Bordeaux, France.
authors.forename: M
authors.initials: M
authors.lastname: Kind
authors.affiliation: Department of Radiology, Pellegrin Hospital, place Amélie-Raba-Léon, 33076 Bordeaux, France.
authors.forename: B
authors.initials: B
authors.lastname: Dallaudière
authors.affiliation: Department of Radiology, Pellegrin Hospital, place Amélie-Raba-Léon, 33076 Bordeaux, France.
authors.forename: O
authors.initials: O
authors.lastname: Hauger
authors.affiliation: Department of Radiology, Pellegrin Hospital, place Amélie-Raba-Léon, 33076 Bordeaux, France. Electronic address: francois.cornelis@chu-bordeaux.fr.
authors.forename: F
authors.initials: F
authors.lastname: Cornelis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D005354:Fibrosarcoma / Q000473:pathology / Q000601:surgery; D006801:Humans; D018208:Liposarcoma, Myxoid / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D018579:Patient Selection; D012509:Sarcoma / Q000473:pathology / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000473:pathology / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Cryoablation; Local recurrence; Soft tissue sarcoma