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European Radiology

, Volume 24, Issue 8, pp 1971–1980 | Cite as

Thermal ablation techniques: a curative treatment of bone metastases in selected patients?

  • F. Deschamps
  • G. Farouil
  • N. Ternes
  • A. Gaudin
  • A. Hakime
  • L. Tselikas
  • C. Teriitehau
  • E. Baudin
  • A. Auperin
  • T. de Baere
Oncology

Abstract

Introduction

Thermal ablation techniques (radiofrequency-ablation/cryotherapy) can be indicated with a curative intent. The success rate and prognostic factors for complete treatment were analysed.

Material/methods

The medical records of all patients who had undergone curatively intended thermal ablation of bone metastases between September 2001 and February 2012 were retrospectively analysed. The goal was to achieve complete treatment of all bone metastases in patients with oligometastatic disease (group 1) or only of bone metastases that could potentially lead to skeletal-related events in patients with a long life expectancy (group 2). We report the rate of complete treatment according to patient characteristics, primary tumour site, bone metastasis characteristics, radiofrequency ablation/cryotherapy and the treatment group (group 1/group 2).

Results

Eighty-nine consecutive patients had undergone curatively intended thermal ablation of 122 bone metastases. The median follow-up was 22.8 months [IQR = 12.2-44.4]. In the intent-to-treat analysis, the 1-year complete treatment rate was 67 % (95%CI: 50 %-76 %). In the multivariate analysis the favourable prognostic factors for complete local treatment were oligometastatic status (p = 0.02), metachronous (p = 0.004) and small-sized (p = 0.001) bone metastases, without cortical bone erosion (p = 0.01) or neurological structures in the vicinity (p = 0.002).

Conclusion

Thermal ablation should be included in the therapeutic arsenal for the cure of bone metastases.

Key Points

Thermal ablation techniques are currently performed to palliate pain caused by bone metastases.

In selected patients, thermal ablation can also be indicated with a curative intent.

Oligometastatic and/or metachronous diseases are good prognostic factors for local success.

Small-size (<2 cm) bone metastases and no cortical erosion are good prognostic factors.

Keywords

Bone metastases Thermal ablation Oligometastases Cryotherapy Radiofrequency ablation 

Abbreviations

SRE

Skeletal-related event

OS

Overall survival

B-DFS

Bone disease-free survival

Notes

Acknowledgements

The scientific guarantor of this publication is Prof. Thierry de Baere. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise (Dr Anne Auperin). Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, observational, performed at one institution.

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Copyright information

© European Society of Radiology 2014

Authors and Affiliations

  • F. Deschamps
    • 1
  • G. Farouil
    • 1
  • N. Ternes
    • 2
  • A. Gaudin
    • 3
  • A. Hakime
    • 1
  • L. Tselikas
    • 1
  • C. Teriitehau
    • 1
  • E. Baudin
    • 4
  • A. Auperin
    • 2
  • T. de Baere
    • 1
  1. 1.Department of Interventional RadiologyVillejuifFrance
  2. 2.Department of Biostatistics and EpidemiologyVillejuifFrance
  3. 3.Department of PharmacyVillejuifFrance
  4. 4.Department of Nuclear Medicine and Endocrine OncologyVillejuifFrance

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