Percutaneous image-guided thermal ablation of bone metastases: a retrospective propensity study comparing the safety profile of radio-frequency ablation and cryo-ablation. (1st January 2020)

• Record Type: Journal Article
• Authors: De Marini, Pierre; Cazzato, Roberto Luigi; Auloge, Pierre; Koch, Guillaume; Dalili, Danoob; Garnon, Julien; Gangi, Afshin
• Is Part Of: International journal of hyperthermia. Volume 37:Number 1(2020)
• Page Start: 1386
• Page End: 1394
• Publication Date: 2020-01-01
• Subjects: Bone metastasis -- radiofrequency therapy -- cryoablation -- ablation techniques -- safety; Thermotherapy -- Periodicals; 615.832
• DOI: 10.1080/02656736.2020.1859628
• Languages: English
• ISSNs: 0265-6736

Abstract

Abstract: Objectives: To retrospectively compare the safety profile of percutaneous image-guided radiofrequency ablation (RFA) and cryoablation (CA) of bone metastases (BM) with and without a propensity score analysis. Methods: Between January 2008 and April 2018, 274 consecutive patients (mean age 61.6 ± 12.1 years) with BM were treated at our Institution with RFA (53 patients; 66 BM) or CA (221 patients; 301 BM) and included in this study. Complications were assessed according to the type of ablation modality before and after applying a 1:1 propensity score method taking into account patient's demographics, BM features, procedural details and follow-up findings. Results: In the whole 9 BM (2.5%) reported major complications without significant difference between RFA (1/66; 1.5%) and CA (8/301; 2.7%; p = 1); 40 BM (10.9%) showed minor complications, which were more common with RFA (22/66; 33.3%) than with CA (18/301; 6.0%, p <.001) mainly due to post-procedural pain occurring more frequently with RFA than CA (20/66; 30.3% vs. 7/301; 2.3%, p <.001). Following 1:1 matching, similar results were obtained, since there were similar rates of major complications with RFA and CA (1/66 [1.5%] and 0/66 [0.0%], respectively; p = 1); and higher rates of minor complications with RFA compared to CA [33.3% (22/66) vs. 2/66 (3%); p <.001] due to preponderant postprocedural pain (90.9% [20/22] minor complications with RFA). Conclusions: Similar low rates of major complications are expected with RFA and CA of BM. In the post-operative period, RFA appears more painful than CA, thus warranting for adoption of dedicated analgesic protocols for patients undergoing RFA.