Percutaneous cryoablation of musculoskeletal oligometastatic disease for complete remission

Purpose: To assess the safety and effectiveness of percutaneous cryoablation to treat limited metastases to the musculoskeletal system, with the goal of complete disease remission. Materials and Methods: In a single-institution retrospective study of data from December 2003 to October 2011, 43 consecutive patients underwent initial cryoablation of limited (five or fewer) musculoskeletal metastases with the goal of complete disease remission (ie, no clinical or radiographic evidence of disease). Three patients were lost to follow-up. As a result, the present report describes 40 patients who underwent 40 cryoablation procedures to treat 52 tumors. Results: Local control was achieved in 45 of 52 tumors (87%; 95% confidence interval [CI], 75%-93%) at a median follow-up of 21 months (range, 4-62 mo). Thirteen of 19 treated bone metastases (68%) and 32 of 33 soft-tissue metastases (97%) showed local control (P =.007). One- and 2-year overall survival rates were 91% (95% CI, 75%-97%) and 84% (95% CI, 65%-93%), respectively. Median overall survival was 47 months (95% CI, 26-62 mo). One- and 2-year disease-free survival rates were 22% (95% CI, 11%-37%) and 7% (95% CI,<1% to 26%), respectively. Median disease-free survival was 7 months (95% CI, 5-10 mo). Two of 40 procedures (5%) were associated with major complications. Conclusions: Percutaneous cryoablation is a safe and effective treatment to achieve local tumor control and short-term complete disease remission in patients with limited metastatic disease to the musculoskeletal system.