Percutaneous Computed Tomography-Guided Thermal Ablation of Pulmonary Osteosarcoma Metastases in Children

Yevich, Steven; Gaspar, Natalie; Tselikas, Lambros; Brugières, Laurence; Pacquement, Hélène; Schleiermacher, G.; Tabone, Marie Dominique; Pearson, Ernesto; Canale, Sandra; Muret, Jane; Baère, Thierry De; Deschamps, Frédèric

doi:10.1245/s10434-015-4988-z

Cited by 28 publications

(24 citation statements)

References 25 publications

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“…The advantages and disadvantages of RFA and surgical resection for the patient with sarcoma lung metastases are summarized in Table 2. The usefulness of combination therapy of RFA and surgical resection has been shown against lung metastases for improvement of curability [7,16].…”

Section: Discussionmentioning

confidence: 99%

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Long-term Survival Following Radiofrequency Ablation of Lung Metastases in an Elderly Patient With Calcaneal Osteosarcoma: a Case Report and Review of the Literature

Futani

Takaki

Sawai

et al. 2021

Preprint

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Background: Lung metastases are the primary cause of death from osteosarcomas. Complete resection of lung metastases can prolong the survival. However, complete surgical resection in elderly patients is often difficult due to high risk of peri-operative complications. Radiofrequency ablation (RFA) is a minimally invasive technique to destroy tumor nodules using heat. Here, we present an elderly patient with osteosarcoma in calcaneus a scapular osteochondroma, who metachoronusly developed multiple lung metastases. Subsequently, he has been surviving a relatively long period by the use of percutaneous computed tomography (CT)-guided lung RFA against his lung metastases.Case presentation: A 74-year-old male presented with 1-year history of heel pain. Imaging analysis demonstrated a mixture of osteolytic and osteosclerotic lesions in the calcaneus with extraskeletal lesions. The histology of the biopsy specimen showed osteoid matrix with malignant spindle cells, which was diagnosed as a conventional high-grade osteosarcoma. Below-knee amputation was performed. However, 6 lung metastases were found in both lungs 1 year after surgery. During 4.5 years from the initial percutaneous CT-guided lung RFA, 18 lung metastases were treated in 8 procedures. Lung RFA was performed under moderate sedation and local anesthesia. The most frequent complication was pneumothoraxes in 3 procedures followed by pleuritis with pneumothorax in 1 procedure. Chest tube drainage was required in 2 of 8 (25%) lung RF procedures. Mean duration of hospital stay for lung RFA was 5.3 ± 2.1 days (range, 3-10 days). The patient has been alive with disease for 5.5 years after initial surgery. Conclusion: Our experience indicates that lung RFA is effective for elderly patients with lung metastases of osteosarcoma without serious complications.

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Section: Discussionmentioning

confidence: 99%

“…The major advantage of RFA is a minimally invasive and relatively safe technique. Recently, a few papers reported the usefulness of this technique against lung metastases of osteosarcomas [7][8][9]. However, the feasibility of this technique has not been reported for elderly patients.…”

Section: Introductionmentioning

confidence: 99%

Long-term Survival Following Radiofrequency Ablation of Lung Metastases in an Elderly Patient With Calcaneal Osteosarcoma: a Case Report and Review of the Literature

Futani

Takaki

Sawai

et al. 2021

Preprint

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“…34 Due to the particular location within the rib cage and the presence of multiple lesions in the same patient, the treatment of choice for this type of lesions has been so far radiofrequency ablation, often CT-guided. 9,10 Finally, angioembolization has been applied in the management of selected patients with nephroblastoma, neuroblastoma, paraganglioma, osteosarcoma, and sarcoma 35 as valuable alternative in case of unresectability or when the conventional therapies had failed as well as magnetic resonance-guided laser interstitial thermal therapy for brain tumors. 23 In this metanalysis, renal tumors mortality was highly reduced (5.43%) in IR group compared to control group (72%) in which IR was not used, highlighting the possible usefulness of these procedures as adjunct to conventional therapies.…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, two papers describing the role of computed tomography (CT)-guided radiofrequency tumor ablation reported local complete ablation following the procedure. In these reports, RFA was performed as palliative approach for metastatic pulmonary tumor in osteosarcoma 9 or various localizations (lung, liver, and bone) with nonspecific primary tumor (osteosarcoma, nephroblastoma, hepatoblastoma, and others) 10 and in both cases the authors report on absence of local recurrence following IR-guided procedure. We evaluated success according to percentage of reduction of the tumor and classified response as poor or good based on a reduction of less or more than 40%, respectively.…”

Section: Study Characteristic: Systematic Reviewmentioning

confidence: 99%

Interventional Radiology-Guided Procedures in the Treatment of Pediatric Solid Tumors: A Systematic Review and Meta-Analysis

et al. 2019

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Introduction The use of interventional radiology (IR) in the treatment of pediatric solid tumors has markedly increased over the last three decades. However, data on effectiveness of IR-techniques, such as embolization/ablation, are scarce. In this systematic review and meta-analysis, we examined the outcomes of IR-procedures in the treatment of solid tumors in children. Materials and Methods Using a defined search strategy, we searched for studies reporting the use of IR-techniques for pediatric solid tumors from 1980 to 2017. Reports with less than three patients, review, and opinion articles were excluded. The study was conducted under preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. We analyzed dichotomous and continuous variables by appropriate statistical methods. Results Of 567 articles screened, 21 papers met the inclusion criteria (12 retrospective, 7 prospective, and 2 randomized-control trials). Many of the analyzed papers described relatively small cohorts of patients. IR-guided procedures were mainly rescue procedures to treat primarily unresectable tumors, local recurrences, or metastases. Inclusion/exclusion criteria and success definition were not specified in most reports. Major side effects were documented in 17/286 (6%) infants, while minor side effects were self-limiting in most patients. Six studies had a comparison between tumor embolization (127 infants) to surgery or chemotherapy without IR-procedures (113 controls). The meta-analysis showed lower mortality (16 vs. 47%) and surgical time for resection (206 vs. 250 m), higher 2-year tumor-free survival (82 vs. 36%), and favorable histology in IR group (p < 0.001 for all). Conclusion IR-guided techniques are promising in the treatment of pediatric solid tumors. Further prospective (randomized) trials are needed to clarify efficacy.

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“…Patients who develop lung metastases after completion of first line therapy, particularly if there is small volume disease and a longer disease-free internal, should be considered for resection as 5 years survival can be 40% in those who achieve a second surgical remission (26). Focal ablation techniques have been demonstrated to achieve local control of small peripheral lung metastases, however, randomised studies are required to define their role in the curative management of patients (27,28). Patients with bone metastases have a much poorer outlook and consideration should be given to maintenance of quality of life.…”

Section: What Is the Optimal Management For Patients With Metastatic mentioning

confidence: 99%

Current questions in bone sarcomas

Strauss

Whelan

2018

Current Opinion in Oncology

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Percutaneous Computed Tomography-Guided Thermal Ablation of Pulmonary Osteosarcoma Metastases in Children

Abstract: Percutaneous thermal ablation is a safe and effective minimally-invasive curative local treatment alternative for children with oligometastatic pulmonary osteosarcoma in whom surgical intervention is clinically contraindicated or unappealing.

Cited by 28 publications

References 25 publications

Long-term Survival Following Radiofrequency Ablation of Lung Metastases in an Elderly Patient With Calcaneal Osteosarcoma: a Case Report and Review of the Literature

Long-term Survival Following Radiofrequency Ablation of Lung Metastases in an Elderly Patient With Calcaneal Osteosarcoma: a Case Report and Review of the Literature

Interventional Radiology-Guided Procedures in the Treatment of Pediatric Solid Tumors: A Systematic Review and Meta-Analysis

Current questions in bone sarcomas

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