>55 years
Soft-tissue cancer mostly affects men over the age of 55, with the mean age at diagnosis being 59 years.2
75%
Primary Soft Tissue Sarcomas represent ~75% of all sarcomas (~ 4-5/ 100,000/ year).3
Desmoid tumours and their impact on quality of life
“I couldn’t even stand up.”
Jessica, patient
Soft tissue tumours subtypes and use of cryoablation
Arise from smooth muscle cells and account for ~10-20% of all soft tissue sarcomas; most commonly found in the uterus, abdomen or pelvis of adultsB,C
Incidence (per 100,000 per year): 0.79A
Use of cryoablation:
- Relevant to a wide range of soft tissue sarcoma subtypes (overall incidence 4-5/ 100,000)D
- Retrospective studies/ case reports support use of CA as an alterative to surgery, or as a Tx option for recurrent disease (with curative intent)E,F,G
- Studies also support use of CA for pain palliation in recurrent/ metastatic diseaseG,H,I
Develop in the skeletal or voluntary muscles, most commonly in the head and neck, but can also occur in the abdomen; most likely to affect children/ adolescentsA,B
Incidence (per 100,000 per year): 0.22A
Use of cryoablation:
- Relevant to a wide range of soft tissue sarcoma subtypes (overall incidence 4-5/ 100,000)D
- Retrospective studies/ case reports support use of CA as an alterative to surgery, or as a Tx option for recurrent disease (with curative intent)E,F,G
- Studies also support use of CA for pain palliation in recurrent/ metastatic diseaseG,H,I
Develop from adipose cells and occur anywhere throughout the body but usually on the trunk, limbs and in the retroperitoneum; most common in adultsB,C
Incidence (per 100,000 per year): 0.51A
Use of cryoablation:
- Relevant to a wide range of soft tissue sarcoma subtypes (overall incidence 4-5/ 100,000)D
- Retrospective studies/ case reports support use of CA as an alterative to surgery, or as a Tx option for recurrent disease (with curative intent)E,F,G
- Studies also support use of CA for pain palliation in recurrent/ metastatic diseaseG,H,I
Develop in the fibrous tissues and can affect nearly all parts of the body (extremities – including pelvic & shoulder girdles, trunk – mostly abdominal wall, and abdominal cavity – mostly within the mesentery of the pelvis); most common in adolescents and young adults, with a high recurrence rate (20-30%)J,K
Incidence (per 100,000 per year): 0.2-0.4 J,K
Use of cryoablation:
- CA included in ESMO guidelines as an option for recurrent extra-abdominal casesL,M
- Some studies also support use of CA as a 1L TxN,O
A rare form of extra-pelvic endometriosis, with the majority of cases occurring following caesarean section or abdominal surgeryQ
Incidence (per 100,000 per year): 2.57 (~1% c-sections per year)*P
Use of cryoablation:
Mayo Clinic indicates that CA is emerging in the Tx algorithm for AWE (precise ice ball visualization, minimal intraprocedural and post-procedure pain); case reports also support useP,Q
Neurofibroma is a type of nerve tumour that forms soft bumps on or under the skin. It affects mostly adults in their 20’s to 40’s.U
Schwannoma develops from Schwann cells, which protect and support the nerve cells of the nervous system. It can affect people of all ages.V
Incidence (per 100,000 per year): 1.2 (Neurofibromatosis type 1)S 1.09 (Vestibular schwannomas)T
Use of cryoablation:
- A recent research includes as a possible alternative treatment option for non-cutaneous PNSTs, mainly benign neurofibromas.W, X
- An article reports a pediatric case of CA as a successful treatment for a plexiform schwannoma near the spinal cord (on a 3-years-old patient), after surgical attempts failed.Y
- Some latest clinical evidences insert Cryoanalgesia as a safe/low risk procedure for pain palliation of peripheral nerve sheath tumours.Z
MPNSTs, or neurofibrosarcomas, develop in the cells that cover and protects peripheral nerves. It can occur anywhere throughout the body. MPNSTs occur mainly in young and middle-aged adults.B,AA
Incidence (per 100,000 per year): 0.3-0.5B
Use of cryoablation:•
- A recent research includes as a possible alternative treatment option for non-cutaneous PNSTs, mainly benign neurofibromas.W, X
- An article reports a pediatric case of CA as a successful treatment for a plexiform schwannoma near the spinal cord (on a 3-years-old patient), after surgical attempts failed.Y
- Some latest clinical evidences insert Cryoanalgesia as a safe/low risk procedure for pain palliation of peripheral nerve sheath tumours.Z
Synovial sarcomas are approximately 10% of all soft tissue sarcomas. They develop in cells around joints and tendons an are more common in young adults, but can also develop in children.B
Incidence (per 100,000 per year): 1-2 per million (USA)BB
Use of cryoablation:
A case study assess the safety and efficacy of CA for palliation and local tumour control in the pediatric/young adult population.CC
GIST is a type of cancer in the gastro-intestinal tract, which starts from cells in connective tissues; it develops most commonly in the stomach (50-70%) and in the small intestine (20-30%) and it usually affects adults in their 55’s to 65’s. EE
Incidence (per 100,000 per year): 1-1.5 DD,EE
Use of cryoablation:
A case study demonstrates how the CA therapy was successfully used on a 69-year-old man to treat esophageal GISTs.FF
Retroperitoneal soft tissue sarcomas (RPSs) are neoplasms that originate in the retroperitoneum. They usually affect adult men in their 60’s, but can occur in almost any age group.HH
Incidence (per 100,000 per year): 0.3-0.4GG
Use of cryoablation:
A recent study demonstrates that minimally invasive percutaneous CA is a safe and efficient treatment for recurrent RPSs.II
Treatment options
Several treatment options are available for soft tissue sarcoma and are chosen depending on the sarcoma subtype (type) and the stage of the disease.
In particular, the soft tissue cancer can be described as5:
- Localised if the tumour cells affect only one area of the body.
- Locally advanced if the tumour attaches to nearby tissues or organs. This usually means it is not possible to remove the tumour because of its location, size, or the organs it involves.
- Metastatic if the sarcoma has reached other parts of the body, away from where it started.
The treatment of Soft Tissue Sarcomas are often "multi-modal”, meaning that it is usual to combine different therapy modalities in incremental, alternating, and sometimes simultaneous ways. The most common treatments are:5,6
- External beam RT (EBRT)
- Surgery
- Chemotherapy
- Targeted Drug Therapy
- Radiofrequency Ablation
- Cryoablation
The treatment strategy depends on different aspects: type of bone cancer, stage of disease and general health status of the patient.
The most common treatments are:1, 3
- External beam RT (EBRT)
- Endocrine treatments
- Surgery
- Chemotherapy
- Immunological therapies
- Radiofrequency Ablation
- Cryoablation
Clinical results – why cryoablation?
Discover cryoablation for soft tissue
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Recent studies show that percutaneous cryoablation could be an effective alternative option to surgery for soft tissue tumours. Indeed, it can not only represent a salvage treatment for both benign and malignant primary soft tissue cancer with curative intent but, thanks to its minimally invasive nature, it is also easy to perform, safe and repeatable.7,8
- No damage to healthy tissue
- Well tolerated procedure
- Prolonged patient survival
94%
Survival rate at 2 years for patients with >95% necrosis.
Defeat pain with cryoablation
Durable pain relief
43%
Mean reduction in worst pain in 4 weeks.14
The effectiveness of cryoablation for palliating pain from cancer metastasis has been reported by many studies12 (i.e. MOTION study); this is also true for Soft Tissue tumours.
Indeed, the Cryoablation treatment seems to be very effective in reducing local pain for recurrent Soft Tissue Sarcoma (RPSs in particular)13 and achieving local tumour control.14,15
Our cryoablation solutions
We offer a broad portfolio of cryoablation systems and needles that provide an efficient treatment against tumours.
With game-changing innovation, we’ve streamlined our technology to meet the practical and efficiency demands of your minimally invasive procedures with no compromise to performance.
References:
1. Soft Tissue Tumour, Airc, 2018. https://www.airc.it/cancro/informazioni-tumori/guida-ai-tumori/sarcoma-dei-tessuti-molli
2. Soft Tissue Sarcoma, Sarcoma Patients EuroNet, 2016. https://www.sarcoma-patients.eu/en/soft-tissue-sarcomas-3
3. Gronchi A, Miah A.B, Dei Tos A.P, et al. Soft tissue and visceral sarcomas: ESMO-EURACAN-GENTURIS Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2021 Jul 22;S0923-7534(21)02184-0. doi: https://doi.org/10.1016/j.annonc.2021.07.006
4. Soft Tissue Sarcoma - Treatment, Sarcoma Patients EuroNet, 2016. https://www.sarcoma-patients.eu/en/soft-tissue-sarcomas-3/soft-tissue-sarcoma-treatment
5. Sarcomas, Soft Tissue: Statistics, Cancer.net, Feb 2021. https://www.cancer.net/cancer-types/sarcomas-soft-tissue/statistics
6. Soft Tissue Sarcoma, Mayo Clinic, Dec 2020. https://www.mayoclinic.org/diseases-conditions/soft-tissue-sarcoma/diagnosis-treatment/drc-20377730
7. Pey M.A, Kind M, Catena V. et al. Cryoablation of benign and malignant soft-tissue tumors: initial experience in a tertiary referral center. ECR 2017 / C-2434. doi: 10.1594/ecr2017/C-2434
8. Lippa N, Sargos P, Italiano A, et al. Standardization of selection criteria for percutaneous image-guided cryoablation of recurrent soft-tissue sarcomas. Diagn Interv Imaging. 2014 Nov;95(11):1071-7. doi: 10.1016/j.diii.2014.02.008
9. Cornelis F, Havez M, Lippa N, et al. Radiologically guided percutaneous cryotherapy for soft tissue tumours: A promising treatment . Diagn Interv Imaging. 2013 Apr;94(4):364-70. doi: 10.1016/j.diii.2013.02.001
10. Fan W, Niu L, Wang Y, et al. Percutaneous computed tomography-guided cryoablation for recurrent retroperitoneal soft tissue sarcoma: a study of safety and efficacy. Oncotarget. 2016 Jul 5;7(27):42639-42649. doi: 10.18632/oncotarget.9476
11. Ahlmann E.R, Falkinstein Y, Fedenko A.N, Menendez L.R. Cryoablation and Resection Influences Patient Survival for Soft Tissue Sarcomas: impact on survivorship and local recurrence. Clin Orthop Relat Res. 2007 Jun;459:174-81. doi: 10.1097/blo.0b013e318059b898
12. Susa M, Kikuta K, Nakayama R, et al. CT guided cryoablation for locally recurrent or metastatic bone and soft tissue tumor: initial experience. BMC Cancer. 2016 Oct 13;16(1):798. doi: 10.1186/s12885-016-2852-6
13. Fan W-Z, Niu L-Z, Wang Y, et al. Initial Experience: Alleviation of Pain with Percutaneous CT-Guided Cryoablation for Recurrent Retroperitoneal Soft-Tissue Sarcoma. J Vasc Interv Radiol. 2016 Dec;27(12):1798-1805. doi: 10.1016/j.jvir.2016.06.034
14. Wallace A.N, McWilliams S.R, Connolly S.E, et al. Percutaneous Image-Guided Cryoablation of Musculoskeletal Metastases: Pain Palliation and Local Tumor Control. J Vasc Interv Radiol. 2016 Dec;27(12):1788-1796. doi: 10.1016/j.jvir.2016.07.026
15. Callstrom M.R, Kurup A.N. Percutaneous ablation for bone and soft tissue metastases—why cryoablation? Skeletal Radiol. 2009 Sep;38(9):835-9. doi: 10.1007/s00256-009-0736-4
A. Amadeo B, Penel N, Coindre J-M, et al. Incidence and time trends of sarcoma(2000–2013): results from the French network of cancer registries (FRANCIM). BMC Cancer. 2020. 20:190. doi: 10.1186/s12885-020-6683-0
B. Soft Tissue Sarcoma Subtypes, Sarcoma Patients EuroNet, 2018. https://www.sarcoma-patients.eu/en/soft-tissue-sarcomas-3/sts-subtypes
C. Leiomyosarcoma, Rare Disease Database. https://rarediseases.org/rare-diseases/leiomyosarcoma/
D. Shidham V.B, et al. Benign and Malignant Soft-Tissue Tumors. Medscape, Aug 10, 2020. https://emedicine.medscape.com/article/1253816-overview#a7
E. Pey M.A, et al. 2017. See note n. 7.
F. Lippa N, et al. 2014. See note n. 8.
G. Susa M, et al. 2016. See note n. 12
H. Kurup N, Morris J M, Callstrom M R. Ablation of Musculoskeletal Metastases, American Journal of Roentgenology. 2017;209: 713-721. doi: 10.2214/AJR.17.18527
I. Wallace A.N, et al. 2016. See note n. 14
J. Desmoid Tumor, Rare Disease Database. https://rarediseases.org/rare-diseases/desmoid-tumor/
K. Desmoids, Sarcoma Patients EuroNet, 2016. https://www.sarcoma-patients.eu/en/desmoids
L. Gronchi A, et al. 2021. See note n. 3.
M. Desmoid Tumor Working Group. The management of desmoid tumours: A joint global consensus-based guideline approach for adult and paediatric patients. Eur J Cancer. 2020 Mar;127:96-107. doi: 10.1016/j.ejca.2019.11.013
N. Tremblay K.R, Lea W.B, Neilson J.C, King D.M, Tutton S.M. Percutaneous cryoablation for the treatment of extra‐abdominal desmoid tumors. J Surg Oncol. 2019 Sep 1; 120(3): 366–375. doi: 10.1002%2Fjso.25597
O. Schmitz J.J, Schmit G.D, Atwell T.D, et al. Percutaneous Cryoablation of Extraabdominal Desmoid Tumors: A 10-Year Experience. American Journal of Roentgenology. 2016;207: 190-195. doi: 10.2214/ajr.15.14391
P. Dibble E.H, D’Amico K.C, Bandera C.A, Littrup P.J. Cryoablation of Abdominal Wall Endometriosis: A Minimally Invasive Treatment. AJR Am J Roentgenol. 2017 Sep;209(3):690-696. doi: 10.2214/ajr.16.17269
Q. Welch B.T, Ehman E.C, VanBuren W.M, et al. Percutaneous cryoablation of abdominal wall endometriosis: the Mayo Clinic approach. Abdominal Radiology volume 45, pages1813–1817 (2020). Doi: 10.1007/s00261-019-02379-4
R. Maiilot J, Brun J.L, Dubuisson V, et al. Mid-term outcomes after percutaneous cryoablation of symptomatic abdominal wall endometriosis: comparison with surgery alone in a single institution. Eur Radiol. 2017 Oct;27(10):4298-4306. doi: 10.1007/s00330-017-4827-7
S. Bata B.M, Hodge D.O, Mohney B.G. Neurofibromatosis Type 1: A Population-Based Study. J Pediatr Ophthalmol Strabismus. 2019 Jul 1;56(4):243-247. doi: 10.3928/01913913-20190321-02
T. Kshettry V. R, Hsieh J.K, Ostrom Q.T, et al. Incidence of vestibular schwannomas in the United States. J Neurooncol. 2015 Sep;124(2):223-8. doi: 10.1007/s11060-015-1827-9
U. Peripheral Nerve Tumors, Mayo Clinic, July 2020. https://www.mayoclinic.org/diseases-conditions/neurofibroma/cdc-20352978
V. Schwannoma, Center for Cancer Institute, July 2020. https://www.cancer.gov/pediatric-adult-rare-tumor/rare-tumors/rare-soft-tissue-tumors/schwannoma
W. Marjanska A, Galazka P, Wysocki M, Styczynski J. New Frontiers in Therapy of Peripheral Nerve Sheath Tumors in Patients With Neurofibromatosis Type 1: Latest Evidence and Clinical Implications. Anticancer Research April 2020, 40 (4) 1817-1831; doi: 10.21873/anticanres.14136
X. Mrowczynski O, Mau C, Nguyen D.T, et al. Percutaneous Radiofrequency Ablation for the Treatment of Peripheral Nerve Sheath Tumors: A Case Report and Review of the Literature. Cureus. 2018 Apr; 10(4): e2534. doi: 10.7759%2Fcureus.2534
Y. Sanchez Y, Shenoy-Bhangle A, Prabhakar A.M, et al. Percutaneous Image-Guided Cryotherapy for Local Control of Recurrent Plexiform Schwannoma in a 3-Year-Old Male. J Vasc Interv Radiol. 2017 May;28(5):766-768. doi: 10.1016/j.jvir.2017.02.010
Z. Filippiadis D, Efthymiou E, Tsochatzis A, et al. Percutaneous cryoanalgesia for pain palliation: Current status and future trends. Diagnostic and Interventional Imaging (IF4.026), Pub Date : 2020-12-03, DOI: 10.1016/j.diii.2020.11.007
AA. Malignant Peripheral Nerve Sheath Tumor, Center for Cancer Institute, July 2020. https://www.cancer.gov/pediatric-adult-rare-tumor/rare-tumors/rare-soft-tissue-tumors/mpnst
BB. Joseph N, St. Laurent S, Nelson J.J, et al. Incidence and prevalence of synovial sarcoma in the US: An analysis using SEER*Stat. Journal of Clinical Oncology (IF44.544), Pub Date : 2019-05-20, DOI: 10.1200/jco.2019.37.15_suppl.e22535
CC. Littrup P, Jaber M, Aoun H, et al. Percutaneous cryoablation with low morbidity in the pediatric and young adult population. Radiological Society of North America 2014 Scientific Assembly and Annual Meeting. Doi: 10.1016/j.jvir.2013.12.349
DD. Stiller C.A, Trama A, Serraino D, et al. Descriptive epidemiology of sarcomas in Europe: Report from the RARECARE project. Cancer Epidemiol 2014; 38: 670-8. doi: 10.1016/j.ejca.2012.09.011
EE. GIST, Sarcoma Patients EuroNet, 2016. https://www.sarcoma-patients.eu/en/gist
FF. Mai D, Hashimoto R, Yu A, et al. Successful Curative Cryoablation of an Esophageal Gastrointestinal Stromal Tumor. ACG Case Rep J. 2019 Jun; 6(6): e00076. doi: 10.14309%2Fcrj.0000000000000076
GG. Francis I.R, Cohan R.H, Varma D.G.K, Sondak V.k. Retroperitoneal sarcomas. Cancer Imaging. 2005; 5(1): 89–94. doi: 10.1102%2F1470-7330.2005.0019
HH. Guzzo T.J, S. Malkowicz B. Chapter 18 - Retroperitoneal Diseases. Penn Clinical Manual of Urology, 2007. doi: 10.1016/B978-141603848-1.10018-X
II. Fan W, et al. 2016. See note n. 10.
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