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Cardiovasc Intervent Radiol. 2018 Aug;41(8):1223-1232. doi: 10.1007/s00270-018-1932-1. Epub 2018 Mar 14.

Radiographic Local Tumor Control and Pain Palliation of Sarcoma Metastases within the Musculoskeletal System with Percutaneous Thermal Ablation.

Author information

1
Mallinckrodt Institute of Radiology, Campus Box 8131, 510 South Kingshighway Boulevard, Saint Louis, MO, 63110, USA. vaswanid@wustl.edu.
2
Mallinckrodt Institute of Radiology, Campus Box 8131, 510 South Kingshighway Boulevard, Saint Louis, MO, 63110, USA.
3
Washington University School of Medicine in St. Louis, 600 Euclid Ave, Saint Louis, MO, 63110, USA.
4
Department of Radiology, Keck School of Medicine of USC, 1500 San Pablo Street, 2nd Floor, Los Angeles, CA, 90033, USA.

Abstract

PURPOSE:

To evaluate the effectiveness of percutaneous image-guided thermal ablation in achieving local tumor control and pain palliation of sarcoma metastases within the musculoskeletal system.

MATERIALS AND METHODS:

Retrospective review of 64 sarcoma metastases within the musculoskeletal system in 26 women and 15 men (total = 41) treated with ablation between December 2011 and August 2016 was performed. Mean age of the cohort was 42.9 years ± 16.0 years. Two subgroups were treated: oligometastatic disease (n = 13) and widely metastatic disease (n = 51). A variety of sarcoma histologies were treated with average tumor volume of 42.5 cm3 (range 0.1-484.7 cm3). Pain scores were recorded before and 4 weeks after therapy for 59% (38/64) of treated lesions. Follow-up imaging was evaluated for local control and to monitor sites of untreated disease as an internal control. Fifty-eight percent (37/64) were lost to imaging follow-up at varying time points over a year. Complication rate was 5% (3/64; one minor and two major events).

RESULTS:

One-year local tumor control rates were 70% (19/27) in all patients, 67% (12/18) in the setting of progression of untreated metastases, and 100% (10/10) in the setting of oligometastatic disease. Median pain scores decreased from 8 (interquartile range 5.0-9.0) to 3 (interquartile range 0.1-4.0) 1 month after the procedure (P < 0.001).

CONCLUSION:

Image-guided percutaneous ablation is an effective option for local tumor control and pain palliation of metastatic sarcomas within the musculoskeletal system. Treatment in the setting of oligometastatic disease offers potential for remission.

LEVEL OF EVIDENCE:

Level 4, Retrospective Review.

KEYWORDS:

Cementoplasty; Cryoablation; Local tumor control; Pain palliation; Radiofrequency ablation; Sarcoma

PMID:
29541840
DOI:
10.1007/s00270-018-1932-1
[Indexed for MEDLINE]

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