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Long-term outcomes after percutaneous cryoablation of abdominal wall endometriosis

  • Vascular-Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To retrospectively evaluate the long-term outcomes after percutaneous cryoablation of abdominal wall endometriosis (AWE).

Method

The Institutional Review Board approved this retrospective observational review of 40 consecutive patients, of a median age of 37 years (interquartile range [IQR] 32–40 years), presenting with a total of 52 symptomatic AWE nodules. All patients underwent cryoablation between January 2013 and May 2022 with a minimum follow-up period of 12 months. Outcomes were assessed using a visual analog scale (VAS) that measured pain, as well as by magnetic resonance imaging (MRI). The pain-free survival rates were derived using the Kaplan–Meier estimator. Adverse events were analyzed and graded using the classification system of the Cardiovascular and Interventional Radiological Society of Europe.

Results

The median follow-up time was 40.5 months (IQR 26.5–47.2 months). The median VAS score before cryoablation was 8 (IQR 7–9). Complete relief of symptoms was documented in 80% (32/40) of patients at 3 months after initial cryoablation and correlated with the absence of residual endometriosis nodules on MRI. The median pain-free survival rates were 89.2% [95% CI, 70.1–96.4%] at 36 months and 76.8% [95% CI, 55.3–83.8%] after 60 months. No patient or lesion characteristics were found to be prognostic of failure. No major adverse events or side effects were reported in long term.

Conclusion

Cryoablation safely and effectively afforded long-term pain relief for patients with AWE nodules.

Clinical relevance statement

AWE cryoablation was found to be safe and effective in the long-term.

Key Points

• Cryoablation is highly effective with 80% of patients experiencing complete relief of AWE symptoms after a single procedure.

• Cryoablation is safe without long-term adverse events or side effects.

• The median pain-free survival rates are 89.2% at 36 months and 76.8% at 60 months.

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Abbreviations

AWE:

Abdominal wall endometriosis

CI:

Confidence interval

CT:

Computed tomography

IQR:

Interquartile range

MRI:

Magnetic resonance imaging

US:

Ultrasound

VAS:

Visual analog scale

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Acknowledgements

MSK is funded through the NIH/NCI Cancer Center Support Grant P30 CA008748.

Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

  1. Centre Hospitalier Universitaire (CHU) de Bordeaux, Service d’imagerie diagnostique et thérapeutique de l’adulte, 3300, Bordeaux, France

    Clément Marcelin, Philippe Maas, Eva Jambon, Rim Maaloum, Isabelle Molina Andreo, Yann Le Bras & Nicolas Grenier

  2. Université de Bordeaux, INSERM, Bordeaux Institute of Oncology, BRIC U1312, 33000, Bordeaux, France

    Clément Marcelin

  3. Clinique Tivoli- Ducos, Institut Franco-Européen Multidisciplinaire d’Endométriose (IFEMEndo), 33000, Bordeaux, France

    Horace Roman

  4. Centre Hospitalier Universitaire (CHU) de Bordeaux, Service de gynécologie, 33000, Bordeaux, France

    Jean-Luc Brun

  5. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA

    Francois H. Cornelis

  6. Weill Cornell Medical College, 1300 York Avenue, New York, NY, 10065, USA

    Francois H. Cornelis

Authors
  1. Clément Marcelin
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  2. Philippe Maas
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  7. Horace Roman
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  8. Nicolas Grenier
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  9. Jean-Luc Brun
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Corresponding author

Correspondence to Clément Marcelin.

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Guarantor

The scientific guarantor of this publication is Francois H. Cornelis, MD, PhD.

Conflict of interest

Francois H. Cornelis is a consultant for GE HealthCare, Varian and IceCure.

The remaining authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

Some study subjects or cohorts have been previously reported in Maillot J, Brun JL, Dubuisson V, Bazot M, Grenier N, Cornelis FH. Mid-term outcomes after percutaneous cryoablation of symptomatic abdominal wall endometriosis: comparison with surgery alone in a single institution. Eur Radiol. oct 2017;27(10):4298‑306.

Methodology

• retrospective

• cross-sectional study

• observational

• performed at one institution

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Marcelin, C., Maas, P., Jambon, E. et al. Long-term outcomes after percutaneous cryoablation of abdominal wall endometriosis. Eur Radiol (2024). https://doi.org/10.1007/s00330-024-10689-5

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