Percutaneous Image-Guided Cryoablation of Musculoskeletal Metastases: Pain Palliation and Local Tumor Control

Adam N. Wallace, Sebastian R. McWilliams, Sarah E. Connolly, John S. Symanski, Devin Vaswani, Anderanik Tomasian, Ross Vyhmeister, Ashley M. Lee, Thomas P. Madaelil, Travis J. Hillen, Jack W. Jennings

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Purpose To evaluate the safety and effectiveness of cryoablation of musculoskeletal metastases in terms of achieving pain palliation and local tumor control. Materials and Methods A retrospective review was performed of 92 musculoskeletal metastases in 56 patients treated with percutaneous image-guided cryoablation. Mean age of the cohort was 53.9 y ± 15.1, and cohort included 48% (27/56) men. Median tumor volume was 13.0 cm3 (range, 0.5–577.2 cm3). Indications for treatment included pain palliation (41%; 38/92), local tumor control (15%; 14/92), or both (43%; 40/92). Concurrent cementoplasty was performed after 28% (26/92) of treatments. Results In 78 tumors treated for pain palliation, median pain score before treatment was 8.0. Decreased median pain scores were reported 1 day (6.0; P < .001, n = 62), 1 week (5.0; P < .001, n = 70), 1 month (5.0; P < .001, n = 63), and 3 months (4.5; P = .01, n = 28) after treatment. The median pain score at 6-month follow-up was 7.5 (P = .33, n = 11). Radiographic local tumor control rates were 90% (37/41) at 3 months, 86% (32/37) at 6 months, and 79% (26/33) at 12 months after treatment. The procedural complication rate was 4.3% (4/92). The 3 major complications included 2 cases of hemothorax and 1 transient foot drop. Conclusions Cryoablation is an effective treatment for palliating painful musculoskeletal metastases and achieving local tumor control.

Original languageEnglish
Pages (from-to)1788-1796
Number of pages9
JournalJournal of Vascular and Interventional Radiology
Volume27
Issue number12
DOIs
StatePublished - Dec 1 2016

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