Brian Faustino Baigorri MD, Presenter: Nothing to Disclose

Peter John Littrup MD, Abstract Co-Author: Founder, CryoMedix, LLC Research Grant, Galil Medical Ltd Research Grant, Endo Health Solutions Inc Officer, Delphinus Medical Technologies, Inc

Hussein D. Aoun MD, Abstract Co-Author: Nothing to Disclose

Barbara A. Adam MSN, Abstract Co-Author: Nothing to Disclose

Mark J. Krycia BS, Abstract Co-Author: Nothing to Disclose

Evan N. Fletcher MS, BA, Abstract Co-Author: Nothing to Disclose

Matthew Prus BS, Abstract Co-Author: Nothing to Disclose

Mohamed M. Jaber MD, Abstract Co-Author: Nothing to Disclose

To assess the safety and efficacy of cryoablation for palliation and local tumor control in the pediatric/young adult oncology population.

CT and/or US-guided percutaneous cryoablations were performed using established adult parameters of N+1 cryoprobes for N(cm) tumor diameter. Ablation locations were noted as head and neck, thoracic, liver, kidney, and soft tissue. Tumor type, complications, and length of stay were recorded. Tumors and ablation zones were measured in 3 planes. Complications were graded by the Common Terminology of Complications and Adverse Events (CTCAE v4.0). Patients received CT or MRI follow-up at 1, 3, 6, 12, 18, 24 months and yearly thereafter.

CT and/or US-guided cryoablation was performed on 111 tumors in 36 pediatric and young adults in 82 procedures. All patients received only conscious sedation. An average age of 23 (range 1.6-38) was observed in the pediatric population due to the proportion of young adult sarcoma patients. Benign tumors included 5 osteoid osteoma and 4 desmoids, and the malignant tumors included 32 alveolar soft part sarcomas, 24 renal cell carcinomas, 13 osteosarcomas, 6 synovial sarcomas, and 37 miscellaneous. Tumor ablation location was noted as: 52 thoracic, 11 liver, 12 kidney, and 36 soft tissue. Patient mortality was 0%, with all adverse events being mild/moderate except for two major complications (2.4%). One was due to a bronchopleural fistula following lung ablation of an osteosarcoma metastasis, and the other was due to anticipated facial edema requiring tracheotomy in a head and neck procedure. Local treatment failure or progression occurred in 2.7%(3/111) and satellite recurrence in 6.3%(7/111) of tumors.

CT guided percutaneous cryoablation is a safe treatment alternative in the pediatric and young adult population with associated low morbidity, and should be considered in the management of oligoneoplastic disease. Multifocal use of cryoablation is safe for pediatric patients with outcomes similar for adults, also emphasizing its low peri-procedural pain.

Like adults, pediatric oncology patients also suffer from the morbidities of managing localized cancer recurrence or progression. Cryoablation provides for low pain, complication and recurrence rates.

Baigorri, B, Littrup, P, Aoun, H, Adam, B, Krycia, M, Fletcher, E, Prus, M, Jaber, M, Palliative Percutaneous Cryoablation in the Pediatric and Young Adult Population.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14019668.html