Noninvasive treatment strategy for abdominal wall desmoid tumors applying high-intensity focused ultrasound

Desmoid tumor (DT) is a rare, locally invasive soft tissue tumor that does not metastasize but has a high recurrence rate after surgery. DTs can be divided into three types: abdominal wall, intra-abdominal and extra-abdominal DTs. The primary treatment options for abdominal wall DT include active surveillance (AS) and surgical resection. However, many patients experience progression during AS, whereas surgical resection carries a high risk of recurrence. Therefore, an effective, noninvasive and safe local treatment method is currently needed in clinical practice.

This study included all patients with abdominal wall DT treated by high-intensity focused ultrasound (HIFU) at the Oncology Department of the Second Affiliated Hospital of Zhejiang University School of Medicine from July 2015 to May 2023. Thermal ablation of the abdominal wall DT was conducted using focused ultrasound beams. Following tumor ablation, treatment outcomes were evaluated for all patients.

A total of 55 abdominal wall DT cases underwent HIFU treatment, including 46 and 9 initial and recurrent tumors, respectively. The median follow-up time was 58 months. The median ablation rate for all patients after 1 month of HIFU treatment was 61%. The objective response rate (ORR) and disease control rate (DCR) were 82% (45/55) and 98% (54/55), respectively. Based on disease course, ORRs were 87% and 56% in treatment-naïve patients and re-treated patients, respectively.

HIFU demonstrates a high DCR for abdominal wall DT with few side effects, representing an effective treatment, especially for treatment-naïve patients.