Thermal-ablation of vertebral metastases prevents adverse events in patients with differentiated thyroid carcinoma. Issue 119 (October 2019)

• Record Type: Journal Article
• Authors: Barat, M.; Tselikas, L.; de Baère, T.; Gravel, G.; Yevich, S.; Delpla, A.; Magand, N.; Louvel, G.; Hadoux, J.; Berdelou, A.; Terroir, M.; Baudin, E.; Schlumberger, M.; Leboulleux, S.; Deschamps, F.
• Is Part Of: European journal of radiology. Issue 119(2019)
• Publication Date: 2019-10
• Subjects: 18FDG 18-fluorodesoxyglucose -- CT computed tomography -- DTC differentiated thyroid carcinoma -- MRI magnetic resonance imaging -- PET positron emission tomography -- SBRT stereotaxic body radiotherapy -- SINS spinal instability neoplastic score -- VM vertebral metastasis -- VRE vertebral related event; Thyroid carcinoma -- Neoplasm metastases -- Ablation techniques/methods -- Spine; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2019.108650
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Thermal-ablation reduce vertebral events in differentiated thyroid cancer metastases. First post-operative imaging is the key to depict residual disease. Residual disease needs additional treatment to achieve local tumor control. Reduction of vertebral events could improve patient life expectancy. Abstract: Purpose: To evaluate a strategy that used thermal-ablation of vertebral metastases (VM) to prevent vertebral related events (VRE) in patients with differentiated thyroid cancer (DTC). Methods: This single center study retrospectively reviewed records and post-operative imaging of all DTC patients treated with thermal-ablation for asymptomatic VMs. Rate of local tumor control at first post-operative imaging, 12 and 24 months after thermal-ablation and rate of VREs at 12 and 24 months among the treated VMs were reported. New VMs that occurred during the follow-up and were not considered for additional thermal-ablation were moniroted and VREs were reported. Results: Thermal-ablation was used to achieve local control of 41 VMs in 28 patients. Median post-treatment follow-up was 22 months [range: 12–80] and the mean delay for first post-operative imaging was 2 months [range: 0.6–7.5]. Local control at first post-operative imaging, 12 and 24 months was achieved in 87.8%, 82.9% and 75.6%, respectively. Among the treated VMs the rates of VRE was 7.3% at 2 years, significantly lower if local control was achieved at first post-operative imaging than if it was not (0% vs 30%, p = 0.011, OR = 0.184 [95%CI = 0.094–0.360]). After thermal-ablation procedures, 19 news VMs occurred in 11 patients (39.2%) with a median interval of 8 months [range 1–26] and remained untreated. Among these untreated VMs, the rate of VREs at 2 years was significantly higher compared to the treated VMs: (36.8% vs. 7.3%, p = 0.008, OR = 0.135, [95%CI = 0.030-0.607]). Conclusion: local tumor control of VMs using thermal-ablation decreases the risk of VREs in DTC patients.