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

  • Devin Vaswani
  • Adam N. Wallace
  • Preston S. Eiswirth
  • Thomas P. Madaelil
  • Randy O. Chang
  • Anderanik Tomasian
  • Jack W. Jennings
Clinical Investigation



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).


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).


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.


Radiofrequency ablation Cryoablation Local tumor control Pain palliation Sarcoma Cementoplasty 


Compliance with Ethical Standards

Conflict of interest

Jack W. Jennings is a paid consultant and is on the medical advisory board and speaker panel for Merit Medical Inc. and Medtronic.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018

Authors and Affiliations

  1. 1.Mallinckrodt Institute of RadiologySaint LouisUSA
  2. 2.Washington University School of Medicine in St. LouisSaint LouisUSA
  3. 3.Department of RadiologyKeck School of Medicine of USCLos AngelesUSA

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