Desmoid tumor cryoablation is an image-guided procedure in which thin needle probes are placed into the tumor under CT or ultrasound and an ice ball freezes and destroys the tumor cells. It needs no incision, only a few needle punctures, and is used for desmoid tumors of the limbs and trunk that keep growing after drug treatment. In the French nationwide phase II trial CRYODESMO-01, 86% of the 50 patients treated had no tumor progression at one year, and pain improved in 83%.
This article draws on an August 2026 review in Current Oncology Reports by interventional radiologists at the University of Alabama at Birmingham, the results of the French CRYODESMO-01 trial, the 2026 US NCCN soft tissue sarcoma guideline, and patient information from the Rare Cancer Center of Japan's National Cancer Center, covering who is treated, the latest results, the procedure, and availability in Japan and abroad.
Treatment status · Cryoablation for desmoid tumors is listed in the 2026 US NCCN guideline as a treatment option for tumors outside the abdomen, such as the limbs and trunk, and is offered at specialist centers in the United States and France. All figures below come from clinical trials and clinical practice in real patients. This article is general information, not a treatment recommendation.
What is a desmoid tumor?
A desmoid tumor is a rare growth that arises from the connective tissue around muscles and tendons. It is also called desmoid-type fibromatosis or aggressive fibromatosis. The World Health Organization classifies it as intermediate between benign and malignant. It does not spread to other organs, but it grows into nearby tissue and can cause pain, limited joint movement, or nerve compression.
According to Japan's Rare Cancer Center, the national soft tissue tumor registry recorded 173 newly diagnosed patients in 2018 and 156 in 2019. Onset peaks around age 40, and women are affected two to three times more often than men. About 90% of cases occur without a family history, mostly in the limbs and trunk. Cases linked to familial adenomatous polyposis are more often inside the abdomen.
Encouragingly, many desmoid tumors do not grow even without treatment. The Japanese guide says about half stay the same size, and the US review notes that 20 to 30% shrink on their own. The international approach is therefore to watch first when symptoms are mild, and to start treatment if the tumor grows or causes symptoms.
How cryoablation works
Cryoablation uses needle-shaped probes that create an ice ball, tens of degrees below zero, at their tips using argon gas. Repeated cycles of freezing and thawing form ice crystals inside and around cells, breaking down the tumor cells. The ice ball is clearly visible on CT, so the doctor can check during the procedure that it covers the whole tumor and adjust its size.
| Item | Cryoablation | Surgery |
|---|---|---|
| Method | Probes inserted through needle punctures to freeze the tumor | Skin incision and removal of the tumor |
| Anesthesia | General anesthesia or deep sedation | General anesthesia |
| Scar | Needle marks a few millimeters wide | Incision scar |
| Repeat treatment | Can be repeated the same way if the tumor regrows | Re-operation may need a wider area |
| Position in NCCN 2026 | Option for extra-abdominal tumors (most used ablation method) | Less-preferred option for extra-abdominal tumors |
Based on the Landinez GP, et al. Curr Oncol Rep 2026 review and its summary of the NCCN soft tissue sarcoma guideline v3.2026.
Freezing is used against other cancers as well. Results for small kidney cancers are in long-term kidney cancer cryoablation results, and breast cancer is covered in breast cancer cryoablation and FDA criteria.
Results of the 50-patient French trial
CRYODESMO-01, funded by the French National Cancer Institute (INCa), was the first prospective multicenter phase II trial of cryoablation for desmoid tumors (ClinicalTrials.gov NCT02476305). It enrolled 50 adults whose desmoid tumors outside the abdomen and pelvis were growing after drug treatment or causing pain or functional problems. Of the participants, 78% were women, the mean age was 41 years, and the median number of prior treatments was two. Tumors were in the trunk (60%), limbs (36%) and neck (4%), with a fairly large median diameter of 10.0 cm.
| Measure | Result | Note |
|---|---|---|
| Non-progression at 1 year | 86% | Primary endpoint, 95% CI 73 to 94% |
| Complete response | 28.6% | No viable tumor seen on 12-month imaging |
| Partial response | 26.2% | Clear tumor shrinkage |
| Stable disease | 31% | No change in size |
| Pain improvement | 83% | Patients with better pain scores |
| Functional improvement | 63% | Patients with better daily function scores |
| Median progression-free survival | Not reached at 31 months | More than half remained progression-free at that point |
CRYODESMO-01: ESMO 2019 abstract and final results cited in the Curr Oncol Rep 2026 review.
The investigators reported that the trial met its primary endpoint and proposed cryoablation by experienced interventional radiologists as an option worthy of guideline inclusion. Grade 3 to 4 adverse events occurred in 11 patients (22%), and all recovered; there were no procedure-related deaths. All recurrences were at the tumor margin, and larger tumors were more likely to leave untreated parts. Building on these results, the French group is running CRYODESMO-02, which compares cryoablation directly with drug treatment.
Pooled results from many countries
The 2026 review brings together studies from several countries rather than a single hospital, including a 2023 meta-analysis of 23 studies with 568 patients and 694 tumors, along with clinical results from US and European hospitals.
| Evidence | Population | Main results |
|---|---|---|
| Meta-analysis (2023) | 23 studies, 568 patients; cryoablation, focused ultrasound, microwave | Local control 88%, symptom relief 90%, major complications 3% |
| Pooled cryoablation series | Retrospective studies from the US and other centers | Disease control 80 to 92%, symptom relief 89 to 97% |
| Progression-free survival after cryoablation | Same studies | About 85% at 1 year, 77 to 83% at 3 years |
| Two systematic reviews | Cryoablation studies combined | Objective response 80%, mean pain reduction 79%, major complications under 5% |
| Children and young people | 21 patients | Pain relief 100%, objective response 90%, minor complications only |
Landinez GP, et al. Percutaneous Management of Desmoid Tumors. Curr Oncol Rep 2026;28:84.
The review concludes that image-guided procedures give local control similar to surgery with a favorable safety profile. In a French analysis of 75 patients, complete coverage of the tumor by the ice ball clearly improved progression-free survival. Where cryoablation is difficult, embolization with drug-eluting beads that block the tumor's blood vessels is also used; in 24 adults, tumor volume fell by a median of 59% after eight months. The basics of embolization are explained in TACE (transarterial chemoembolization) guide.
Where cryoablation sits in 2026 guidelines
The US NCCN soft tissue sarcoma guideline v3.2026 lists ablation and embolization alongside drug therapy and radiation for extra-abdominal desmoid tumors (abdominal wall, pelvis, limbs and trunk, head and neck, chest) that are growing or causing symptoms. The international Desmoid Tumor Working Group also recognized local ablative techniques in its 2024 consensus and recommended review by an expert multidisciplinary team.
| Stage | Approach | Note |
|---|---|---|
| First | Active surveillance | Watch first if symptoms are mild and the location is not critical |
| If it grows or causes symptoms | Drug therapy | Nirogacestat phase III: 71% lower risk of progression, response rate 41% |
| Extra-abdominal tumors | Cryoablation | Most used ablation method; also used as maintenance after drugs have stabilized the tumor |
| If cryoablation is not feasible | Drug-eluting bead embolization | Blocks tumor vessels to reduce volume |
| Intra-abdominal tumors | Drug therapy and surgery | Freezing near the bowel is harder to control, so the main options differ |
NCCN guideline v3.2026 content follows the summary in the Curr Oncol Rep 2026 review.
Who is a candidate?
- Growing tumors: growth confirmed on imaging during surveillance. Because some tumors shrink on their own, the review advises documenting progression before treatment.
- Symptomatic tumors: pain, limited joint movement or nerve compression that interferes with daily life.
- Outside the abdomen: limbs, trunk, abdominal wall or neck, where needles can be placed safely.
- Size: tumors smaller than about 7 to 10 cm suit best; larger ones may be treated in stages.
- After drug therapy: also used to maintain control once drugs have stabilized the tumor.
The review notes that radiotherapy is avoided under age 18, and the 21-patient pediatric study showed good results with cryoablation, which makes it especially meaningful for young patients. Heat and cold treatments for bone pain are also covered in ablation for bone metastasis pain.
Japan and other countries
| Region | Status | Basis |
|---|---|---|
| United States | Listed in NCCN guideline v3.2026 as an option for extra-abdominal tumors; offered by university interventional radiology departments | Curr Oncol Rep 2026 review |
| France | Phase II trial funded by the national cancer institute completed; CRYODESMO-02 comparing with drug therapy under way | NCT02476305, review |
| Japan | The Rare Cancer Center's guide focuses on surveillance, drug therapy and function-sparing surgery | National Cancer Center Rare Cancer Center (Japanese-language source) |
International patients are often not covered by the host country's public insurance, so confirm costs and schedules directly with the hospital.
Japan's Rare Cancer Center stresses accurate diagnosis with MRI and biopsy at a specialist hospital, because desmoid tumors are hard to diagnose. A French survey found that about 29% were initially misdiagnosed outside expert centers. If you are considering cryoablation, have the diagnosis reconfirmed at a hospital with desmoid experience and ask whether its interventional radiology team performs cryoablation. An overview of the field is in our IVR (interventional radiology) guide.
Questions to ask your doctors
- Is my tumor growing now, or is it at a stage where we can watch it?
- Given its location and size, can the ice ball cover the whole tumor?
- How will nearby nerves and skin be protected?
- Can it be done in one session, or will it need several?
- When and how often will I have MRI scans afterwards?
For preparing a consultation, see also five questions to ask before RFA.
Frequently asked questions
Is a desmoid tumor cancer?
The World Health Organization classifies it as intermediate between benign and malignant. It does not spread to other organs but can grow into nearby tissue, so it is often managed together with soft tissue sarcoma specialists.
How long is recovery after cryoablation?
Because it is done through needle punctures, it places less strain on the body than open surgery. Hospital stay depends on the hospital and tumor size, so check in advance. The frozen area may swell or ache and is managed with pain relief; in the French trial, pain improved in 83% of patients.
Will the tumor stay controlled after cryoablation?
In the French trial, 86% were progression-free at one year, and across studies three-year progression-free survival was 77 to 83%. If the margin regrows, it can be treated again the same way, so regular MRI follow-up is important.
Which comes first, drug therapy or cryoablation?
It depends on location, size, symptoms and prior treatment. The NCCN guideline lists both as options for extra-abdominal tumors, and cryoablation can also maintain control after drugs have stabilized the tumor. The decision is made with a multidisciplinary team.
This article summarises overseas official sources and studies as general information and is not medical advice. Discuss treatment choices with a doctor who has examined you.
Sources (checked October 28, 2026)
- Landinez GP, Ramasamy SK, Wu X, et al. Percutaneous Management of Desmoid Tumors. Current Oncology Reports. 2026;28:84.
- CRYODESMO-01. A French nationwide phase II study on cryoablation in progressing desmoid tumor patients. ESMO 2019 Congress abstract.
- ClinicalTrials.gov. NCT02476305: Cryoablation in desmoid tumours (CRYODESMO-01).
- National Cancer Center Japan, Rare Cancer Center. Patient guide to desmoid tumors (Japanese-language source, 2022).