Percutaneous Thermal Ablation Of Sacral Metastases: Assessment Of Pain Relief And Local Tumor Control

Purpose: To retrospectively report on safety, pain relief and local tumor control achieved with percutaneous ablation of sacral bone metastases.Materials and methods: From February 2009 to June 2020, 23 consecutive patients (12 women and 11 men; mean age, 60 +/- 8 [SD] years; median, 60; range: 48-80 years) with 23 sacral metastases underwent radiofrequency (RFA) or cryo-ablation (CA), with palliative or curative intent at our institution. Patients' demographics and data pertaining to treated metastases, procedure-related variables, safety, and clinical evolution following ablation were collected and analyzed. Pain was assessed with numerical pain rating scale (NPRS).Results: Sixteen (70%) patients were treated with palliative and 7 (30%) with curative intent. Mean tumor diameter was 38 +/- 19 (SD) mm (median, 36; range: 11-76). External radiation therapy had been performed on five metastases (5/23; 22%) prior to ablation. RFA was used in 9 (39%) metastases and CA in the remaining 14 (61%). Thermo-protective measures and adjuvant bone consolidation were used whilst treating 20 (87%) and 8 (35%) metastases, respectively. Five (22%) minor complications were recorded. At mean 31 +/- 21 (SD) (median, 32; range: 2-70) months follow-up mean NPRS was 2 +/- 2 (SD) (median, 1; range: 0-6) vs. 5 +/- 1 (median, 5; range: 4-8; P < 0.001) at the baseline. Three metastases out of 7 (43%) undergoing curative ablation showed local progression at mean 4 +/- 4 (SD) (median, 2; range: 1-8) months follow-up.Conclusion: Percutaneous ablation of sacral metastases is safe and results in significant long-lasting pain relief. Local tumor control seems sub-optimal; however, further investigations are needed to confirm these findings due to paucity of data. (C) 2021 Societe francaise de radiologie. Published by Elsevier Masson SAS. All rights reserved.