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Purpose: To evaluate outcomes following percutaneous image‐guided ablation of soft tissue sarcoma metastases to the liver. Materials and Methods: A single‐institution retrospective analysis of patients with a diagnosis of metastatic soft tissue sarcoma who underwent percutaneous image‐guided ablation of hepatic metastases between January 2011 and December 2021 was performed. Patients with less than 60 days of follow‐up after ablation were excluded. The primary outcome was local tumor progression‐free survival (LPFS). Secondary outcomes included overall survival, liver‐specific progression‐free survival. and chemotherapy‐free survival. Results: Fifty‐five patients who underwent percutaneous ablation for 84 metastatic liver lesions were included. The most common histopathological subtypes were leiomyosarcoma (23/55), followed by gastrointestinal stromal tumor (22/55). The median treated liver lesions was 2 (range, 1–8), whereas the median size of metastases were 1.8 cm (0.3–8.7 cm). Complete response at 2 months was achieved in 90.5% of the treated lesions. LPFS was 83% at 1 year and 80% at 2 years. Liver‐specific progression‐free survival was 66% at 1 year and 40% at 2 years. The overall survival at 1 and 2 years was 98% and 94%. The chemotherapy‐free holiday from the start of ablation was 71.2% at 12 months. The complication rate was 3.6% (2/55); one of the complications was Common Terminology Criteria for Adverse Events grade 3 or higher. LPFS subgroup analysis for leiomyosarcoma versus gastrointestinal stromal tumor suggests histology‐agnostic outcomes (2 years, 89% vs 82%, p =.35). Conclusion: Percutaneous image‐guided liver ablation of soft tissue sarcoma metastases is safe and efficacious. Image‐guided ablation of sarcoma metastasis is a promising modality for treating sarcoma metastases to the liver, with a local tumor progression‐free survival of 83% and 80% at 1 and 2 years. Subgroup analysis demonstrated no significant differences between the local tumor progression‐free survival of gastrointestinal stromal tumor versus leiomyosarcoma, suggesting a histology‐agnostic treatment paradigm. [ABSTRACT FROM AUTHOR]

Background: The objective of this study was to evaluate treatment outcomes for patients with desmoid tumors (DTs) receiving local therapy with surgery alone, radiation therapy (RT) alone, or combined modality therapy (RT and surgery).Methods: This was a cross-sectional cohort study of 412 patients with nonmesenteric DTs who received local therapy at the authors' institution between 1965 and 2018.Results: The median follow-up time was 95 months (range, 1-509 months). Local recurrence occurred in 127 patients (31%) at a median time of 21 months (interquartile range, 12-38 months). The 5-year local control (LC) rate was 67%. Patient or tumor factors that were significantly associated with poorer 5-year LC in a multivariable analysis included an age ≤ 30 years (57% vs 75% for an age > 30 years; hazard ratio [HR], 1.73; P = .004), an extremity location (57% vs 71% for a nonextremity location; HR, 1.77; P = .004), and large tumors (59% for >10 cm [HR, 2.17; P = .004] and 65% for 5.1-10 cm [HR, 1.71; P = .02] vs 76% for ≤5 cm). Subset analyses of these high-risk patients revealed no local therapy strategy to be superior for young patients ≤ 30 years old (HR for surgery, 1.42; P = .33; HR for RT, 1.36; P = .38) or for large tumors > 10 cm (HR for surgery, 1.55; P = .46; HR for RT, 0.91; P = .91). However, for patients with extremity tumors, surgery alone was significantly associated with inferior LC (HR for surgery, 5.15; P < .001; HR for RT, 1.51; P = .38).Conclusions: Local therapy provides durable tumor control in the majority of patients with DTs. However, young patients, patients with an extremity location, and patients with large tumors are at increased risk of recurrence. When active treatment is indicated, systemic therapy should perhaps be considered as a first-line option in these high-risk subsets. Prospective multi-institutional studies evaluating this strategy are warranted. [ABSTRACT FROM AUTHOR]