Frederic Deschamps, Presenter: Nothing to Disclose

Geoffroy Farouil, Abstract Co-Author: Nothing to Disclose

Lambros Charles Tselikas MD, Abstract Co-Author: Nothing to Disclose

Thierry J. De Baere MD, Abstract Co-Author: Consultant, Terumo Corporation Speaker, Covidien AG Speaker, Terumo Corporation Speaker, General Electric Company Consultant, General Electric Company Consultant, Guerbet SA Speaker, Guerbet SA

To determine prognostic factor(s) for complete thermal ablation (TA) of bones metastases

The medical records of all the patients who had undergone curative-intent TA of bone metastases in our Institution between September 2001 and February 2012 were retrospectively reviewed. The goal of the TA was to achieve a local tumor control in order to cure all bone metastases in oligometastatic patients or to prevent the occurrence of skeletal-related events in long life expectancy cancer patients. We have analyzed the rate of complete treatment at 1 year according to the patients’ details -gender, age, site of the primary tumor- and the bone metastases’ characteristics -synchronicity with the primary tumor, already treated by external radiotherapy, local evolution within 3 months before the procedure (RECIST criteria), location (axial vs. appendicular), maximal diameter at baseline CT, condensation aspect at CT (lytic vs. sclerotic), bone cortical erosion, critical neurological structures in the vicinity (less than 10mm), TA technique used (radiofrequency ablation vs. cryoablation)-.

Eighty-nine consecutive patients underwent TA in a curative-intent of 124 bone metastases. The median follow-up was 22.8 months [12.2 to 44.4 months). We report a 67% of complete treatment at 1 year. In multivariate analysis the good prognostic factors for complete treatment were: metachronous bone metastasis (p=0.004), no progression within 3 months before (p=0.004), no cortical erosion (p=0.01), maximal diameter <20 mm (p=0.001), no critical neurological structures in the vicinity (p=0.002). A higher risk of incomplete treatment was related neither to the patients’ details nor to the site of the primary tumor nor to the previous radiotherapy, nor to the location, nor to the previous number of bone metastases in the antecedent, nor to the condensation aspect at CT, nor to the TA technique used (radiofrequency ablation or cryoablation).

Thermal ablation techniques are effective to cure small (<20mm), metachronous and stable bone metastases.

Thermal ablation techniques must be considered in oligometastatic patients or in long life expectancy cancer patients with bone metastases.

Deschamps, F, Farouil, G, Tselikas, L, De Baere, T, Thermal Ablation Techniques for Curative Treatment of Bone Metastases.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13014660.html