Over ten years of single-institution experience in percutaneous image-guided treatment of bone metastases from differentiated thyroid cancer

Eur J Surg Oncol. 2015 Sep;41(9):1247-55. doi: 10.1016/j.ejso.2015.06.005. Epub 2015 Jun 21.

Abstract

Objective: Percutaneous image-guided treatments (PIGT) are performed by interventional radiologists with a minimally invasive approach. Currently, very little published data on their outcomes are available and conclusions regarding their application are cautious. The aim of the present study was to review our experience in PIGT of bone metastases from thyroid cancer.

Materials and methods: Institutional databases were reviewed to identify patients with differentiated thyroid cancer and bone metastases who received PIGT between October 2001 and April 2014. Complications, local evolution of the treated lesions, and overall survival (OS) were investigated.

Results: Twenty-five patients (12 male, 13 female) underwent 49 PIGT sessions consisting of cementoplasty (77.5%), cryoablation (14.3%) or radiofrequency ablation (8.2%). Most of the treated lesions (50/54, 92.6%) were symptomatic at the time of PIGT. Median follow-up after PIGT was 4.6 years. Local complete remission rate was 55.6%. Two complications (one major and one minor) were noted, but none of these were consistent with fractures or nervous system injuries. OS after PIGT was 71.6%, 66.8% and 60.1% at 1, 2 and 3 years, respectively. A difference in survival was observed between patients with metastatic bone involvement only at the time of first PIGT compared to those with multi-organ involvement (P = 0.03).

Conclusions: Patients with bone metastases from differentiated thyroid cancer may benefit from PIGT. Although patients are usually referred for PIGT due to their symptomatic status, a more relevant "curative" role may exist for PIGT. Further prospective studies are needed to confirm this perception.

Keywords: Bone metastases; Cementoplasty; Cryosurgery; Overall survival; Thermal ablation; Thyroid cancer.

MeSH terms

  • Adenocarcinoma / secondary
  • Adenocarcinoma / surgery*
  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Neoplasms / secondary
  • Bone Neoplasms / surgery*
  • Catheter Ablation / methods*
  • Cementoplasty / methods*
  • Cohort Studies
  • Cryosurgery / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Surgery, Computer-Assisted
  • Thyroid Neoplasms / pathology*