Percutaneous cryoablation of musculoskeletal oligometastatic disease for complete remission

Brendan P. McMenomy, A. Nicholas Kurup, Geoffrey B. Johnson, Rickey E. Carter, Robert R Mc Williams, Svetomir Nenad Markovic, Thomas D. Atwell, Grant D. Schmit, Jonathan M. Morris, David A Woodrum, Adam J. Weisbrod, Peter S. Rose, Matthew R Callstrom

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)207-213
Number of pages7
JournalJournal of Vascular and Interventional Radiology
Volume24
Issue number2
DOIs
StatePublished - Feb 2013

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Musculoskeletal Diseases
Cryosurgery
Confidence Intervals
Neoplasm Metastasis
Musculoskeletal System
Disease-Free Survival
Survival Rate
Neoplasms
Lost to Follow-Up
Retrospective Studies
Safety
Bone and Bones
Survival

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Percutaneous cryoablation of musculoskeletal oligometastatic disease for complete remission. / McMenomy, Brendan P.; Kurup, A. Nicholas; Johnson, Geoffrey B.; Carter, Rickey E.; Mc Williams, Robert R; Markovic, Svetomir Nenad; Atwell, Thomas D.; Schmit, Grant D.; Morris, Jonathan M.; Woodrum, David A; Weisbrod, Adam J.; Rose, Peter S.; Callstrom, Matthew R.

In: Journal of Vascular and Interventional Radiology, Vol. 24, No. 2, 02.2013, p. 207-213.

Research output: Contribution to journalArticle

McMenomy, Brendan P. ; Kurup, A. Nicholas ; Johnson, Geoffrey B. ; Carter, Rickey E. ; Mc Williams, Robert R ; Markovic, Svetomir Nenad ; Atwell, Thomas D. ; Schmit, Grant D. ; Morris, Jonathan M. ; Woodrum, David A ; Weisbrod, Adam J. ; Rose, Peter S. ; Callstrom, Matthew R. / Percutaneous cryoablation of musculoskeletal oligometastatic disease for complete remission. In: Journal of Vascular and Interventional Radiology. 2013 ; Vol. 24, No. 2. pp. 207-213.
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abstract = "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.",
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T1 - Percutaneous cryoablation of musculoskeletal oligometastatic disease for complete remission

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AU - Kurup, A. Nicholas

AU - Johnson, Geoffrey B.

AU - Carter, Rickey E.

AU - Mc Williams, Robert R

AU - Markovic, Svetomir Nenad

AU - Atwell, Thomas D.

AU - Schmit, Grant D.

AU - Morris, Jonathan M.

AU - Woodrum, David A

AU - Weisbrod, Adam J.

AU - Rose, Peter S.

AU - Callstrom, Matthew R

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N2 - 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.

AB - 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.

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