Cryoablation of sternal metastases for pain palliation and local tumor control

Ryan M. Hegg, Anil Nicholas Kurup, Grant D. Schmit, Adam J. Weisbrod, Thomas D. Atwell, Kenneth R. Olivier, Timothy J. Moynihan, Matthew R Callstrom

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Abstract

Purpose: To determine safety and effectiveness of cryoablation of sternal metastases for pain palliation and local tumor control. Materials and Methods: A tumor ablation database was retrospectively reviewed for sternal cryoablation procedures performed between January 2005 and June 2013, which yielded 15 procedures to treat 12 sternal metastases in 12 patients (five men). Median patient age was 57 years (range, 38-80 y). Metastases arose from five primary sites (breast, lung, kidney, ampulla, and thyroid), and median tumor size was 3.8 cm (range, 2.2-7.5 cm). Seven patients (58%) underwent cryoablation for pain palliation, and five (42%) underwent cryoablation for local tumor control of oligometastatic disease. Clinical outcomes (including complications, local tumor control, and pain response) were evaluated retrospectively. Results: Mean pain scores decreased from 7.0 ± 1.9 (median, 7; range, 4-10) at baseline to 1.8 ± 1.2 (median, 1.5; range, 0-4) following cryoablation (P = .00049). Two patients had durable pain palliation, and four had greater than 1 month of pain relief, with a median duration of 5.7 months (range, 1.5-14.7 mo). Two patients in whom recurrent pain developed underwent repeat cryoablation, with durable pain relief. Allowing for a single repeat treatment local tumor control was achieved in four of five patients (80%) treated for this indication, with median follow-up of 8.4 months (range, 2.6-13.6 mo). In one patient (8%), an infectious complication developed that was successfully treated with antibiotics on an outpatient basis. Conclusions: Cryoablation is a safe and potentially effective treatment for patients with painful sternal metastases and can achieve local tumor control in select patients.

Original languageEnglish (US)
Pages (from-to)1665-1670
Number of pages6
JournalJournal of Vascular and Interventional Radiology
Volume25
Issue number11
StatePublished - 2014

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Cryosurgery
Neoplasm Metastasis
Pain
Neoplasms
Thyroid Gland
Breast
Outpatients
Databases
Anti-Bacterial Agents
Kidney
Safety
Lung

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Hegg, R. M., Kurup, A. N., Schmit, G. D., Weisbrod, A. J., Atwell, T. D., Olivier, K. R., ... Callstrom, M. R. (2014). Cryoablation of sternal metastases for pain palliation and local tumor control. Journal of Vascular and Interventional Radiology, 25(11), 1665-1670.

Cryoablation of sternal metastases for pain palliation and local tumor control. / Hegg, Ryan M.; Kurup, Anil Nicholas; Schmit, Grant D.; Weisbrod, Adam J.; Atwell, Thomas D.; Olivier, Kenneth R.; Moynihan, Timothy J.; Callstrom, Matthew R.

In: Journal of Vascular and Interventional Radiology, Vol. 25, No. 11, 2014, p. 1665-1670.

Research output: Contribution to journalArticle

Hegg, RM, Kurup, AN, Schmit, GD, Weisbrod, AJ, Atwell, TD, Olivier, KR, Moynihan, TJ & Callstrom, MR 2014, 'Cryoablation of sternal metastases for pain palliation and local tumor control', Journal of Vascular and Interventional Radiology, vol. 25, no. 11, pp. 1665-1670.
Hegg RM, Kurup AN, Schmit GD, Weisbrod AJ, Atwell TD, Olivier KR et al. Cryoablation of sternal metastases for pain palliation and local tumor control. Journal of Vascular and Interventional Radiology. 2014;25(11):1665-1670.
Hegg, Ryan M. ; Kurup, Anil Nicholas ; Schmit, Grant D. ; Weisbrod, Adam J. ; Atwell, Thomas D. ; Olivier, Kenneth R. ; Moynihan, Timothy J. ; Callstrom, Matthew R. / Cryoablation of sternal metastases for pain palliation and local tumor control. In: Journal of Vascular and Interventional Radiology. 2014 ; Vol. 25, No. 11. pp. 1665-1670.
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abstract = "Purpose: To determine safety and effectiveness of cryoablation of sternal metastases for pain palliation and local tumor control. Materials and Methods: A tumor ablation database was retrospectively reviewed for sternal cryoablation procedures performed between January 2005 and June 2013, which yielded 15 procedures to treat 12 sternal metastases in 12 patients (five men). Median patient age was 57 years (range, 38-80 y). Metastases arose from five primary sites (breast, lung, kidney, ampulla, and thyroid), and median tumor size was 3.8 cm (range, 2.2-7.5 cm). Seven patients (58{\%}) underwent cryoablation for pain palliation, and five (42{\%}) underwent cryoablation for local tumor control of oligometastatic disease. Clinical outcomes (including complications, local tumor control, and pain response) were evaluated retrospectively. Results: Mean pain scores decreased from 7.0 ± 1.9 (median, 7; range, 4-10) at baseline to 1.8 ± 1.2 (median, 1.5; range, 0-4) following cryoablation (P = .00049). Two patients had durable pain palliation, and four had greater than 1 month of pain relief, with a median duration of 5.7 months (range, 1.5-14.7 mo). Two patients in whom recurrent pain developed underwent repeat cryoablation, with durable pain relief. Allowing for a single repeat treatment local tumor control was achieved in four of five patients (80{\%}) treated for this indication, with median follow-up of 8.4 months (range, 2.6-13.6 mo). In one patient (8{\%}), an infectious complication developed that was successfully treated with antibiotics on an outpatient basis. Conclusions: Cryoablation is a safe and potentially effective treatment for patients with painful sternal metastases and can achieve local tumor control in select patients.",
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AU - Hegg, Ryan M.

AU - Kurup, Anil Nicholas

AU - Schmit, Grant D.

AU - Weisbrod, Adam J.

AU - Atwell, Thomas D.

AU - Olivier, Kenneth R.

AU - Moynihan, Timothy J.

AU - Callstrom, Matthew R

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N2 - Purpose: To determine safety and effectiveness of cryoablation of sternal metastases for pain palliation and local tumor control. Materials and Methods: A tumor ablation database was retrospectively reviewed for sternal cryoablation procedures performed between January 2005 and June 2013, which yielded 15 procedures to treat 12 sternal metastases in 12 patients (five men). Median patient age was 57 years (range, 38-80 y). Metastases arose from five primary sites (breast, lung, kidney, ampulla, and thyroid), and median tumor size was 3.8 cm (range, 2.2-7.5 cm). Seven patients (58%) underwent cryoablation for pain palliation, and five (42%) underwent cryoablation for local tumor control of oligometastatic disease. Clinical outcomes (including complications, local tumor control, and pain response) were evaluated retrospectively. Results: Mean pain scores decreased from 7.0 ± 1.9 (median, 7; range, 4-10) at baseline to 1.8 ± 1.2 (median, 1.5; range, 0-4) following cryoablation (P = .00049). Two patients had durable pain palliation, and four had greater than 1 month of pain relief, with a median duration of 5.7 months (range, 1.5-14.7 mo). Two patients in whom recurrent pain developed underwent repeat cryoablation, with durable pain relief. Allowing for a single repeat treatment local tumor control was achieved in four of five patients (80%) treated for this indication, with median follow-up of 8.4 months (range, 2.6-13.6 mo). In one patient (8%), an infectious complication developed that was successfully treated with antibiotics on an outpatient basis. Conclusions: Cryoablation is a safe and potentially effective treatment for patients with painful sternal metastases and can achieve local tumor control in select patients.

AB - Purpose: To determine safety and effectiveness of cryoablation of sternal metastases for pain palliation and local tumor control. Materials and Methods: A tumor ablation database was retrospectively reviewed for sternal cryoablation procedures performed between January 2005 and June 2013, which yielded 15 procedures to treat 12 sternal metastases in 12 patients (five men). Median patient age was 57 years (range, 38-80 y). Metastases arose from five primary sites (breast, lung, kidney, ampulla, and thyroid), and median tumor size was 3.8 cm (range, 2.2-7.5 cm). Seven patients (58%) underwent cryoablation for pain palliation, and five (42%) underwent cryoablation for local tumor control of oligometastatic disease. Clinical outcomes (including complications, local tumor control, and pain response) were evaluated retrospectively. Results: Mean pain scores decreased from 7.0 ± 1.9 (median, 7; range, 4-10) at baseline to 1.8 ± 1.2 (median, 1.5; range, 0-4) following cryoablation (P = .00049). Two patients had durable pain palliation, and four had greater than 1 month of pain relief, with a median duration of 5.7 months (range, 1.5-14.7 mo). Two patients in whom recurrent pain developed underwent repeat cryoablation, with durable pain relief. Allowing for a single repeat treatment local tumor control was achieved in four of five patients (80%) treated for this indication, with median follow-up of 8.4 months (range, 2.6-13.6 mo). In one patient (8%), an infectious complication developed that was successfully treated with antibiotics on an outpatient basis. Conclusions: Cryoablation is a safe and potentially effective treatment for patients with painful sternal metastases and can achieve local tumor control in select patients.

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