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Percutaneous Computed Tomography-Guided Thermal Ablation of Pulmonary Osteosarcoma Metastases in Children

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Introduction

The role of percutaneous thermal ablation as a minimally-invasive treatment has not been evaluated in children under 18 years of age with pulmonary osteosarcoma metastases.

Methods

This was a retrospective review of children treated with percutaneous thermal ablation for pulmonary osteosarcoma metastasis after prior surgical metastasectomy and chemotherapy. Selection criteria included number of pulmonary nodules <5 and nodule size smaller than 2 cm. Indications were discussed at multidisciplinary meetings. The goal was to achieve complete remission using percutaneous thermal ablation, thereby avoiding additional thoracotomies.

Results

A total of 26 pulmonary nodules (mean size 6.7 mm, range 2–16 mm) were successfully treated by percutaneous computed tomography (CT)-guided thermal ablation in 11 children with osteosarcoma between the ages of 7 and 17 years (median 12.5). Patients denied post-procedure pain. Complications were limited to three pneumothoraxes (two minor, one major), and median hospitalization duration was 2.0 days. One patient died of rapidly progressive lumbar metastasis discovered 20 days post-ablation. Of the remaining 10 patients, local control at the ablation site was achieved, with median follow up of 16.7 months (range 4.1–41.8). Five patients remained in complete remission after median follow-up of 37.5 months, and five patients developed new metastases (one osseous, four pulmonary), of which two are in remission after subsequent treatment.

Conclusion

Percutaneous thermal ablation is a safe and effective minimally-invasive curative local treatment alternative for children with oligometastatic pulmonary osteosarcoma in whom surgical intervention is clinically contraindicated or unappealing.

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Acknowledgment

Steven Yevich is the overall guarantor of this work and takes responsibility for the integrity of the data and the accuracy of the data analysis, including, in particular, any adverse effects. Natalie Gaspar, Lambros Tselikas, Hélène Pacquement, Gudren Schleiermacher, Marie-Dominique Tabone, Ernesto Pearson, Sandra Canale, Jane Muret, Thierry de Baere, and Frederic Deschamps contributed to the study design and clinical coordination; Steven Yevich, Natalie Gaspar, Laurence Brugières, Lambros Tselikas, and Frederic Deschamps contributed to data analysis; and Steven Yevich, Natalie Gaspar, Laurence Brugières, and Frederic Deschamps contributed substantially to the writing of the manuscript.

Financial Disclosures

No funding was obtained for the completion of this study, and the authors have no financial assistance to disclose.

Conflict of interest

None declared. No conflicts of interests are present for the authors, including financial, personal, or other relationships with other people or organizations within that could inappropriately influence this submission.

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Authors and Affiliations

  1. Interventional Radiology Department, Gustave Roussy Cancer Campus Grand Paris, Villejuif, France

    Steven Yevich MD, Lambros Tselikas MD, Ernesto Pearson MD, Thierry de Baere MD & Frederic Deschamps MD

  2. Anesthesia Department, Gustave Roussy Cancer Campus Grand Paris, Villejuif, France

    Jane Muret MD

  3. Pediatric and Teenage Oncology Department, Gustave Roussy Cancer Campus Grand Paris, Villejuif, France

    Natalie Gaspar MD & Laurence Brugières MD

  4. Interventional Radiology Department, University Paris – Sud, Kremlin Bicetre, France

    Lambros Tselikas MD, Thierry de Baere MD & Frederic Deschamps MD

  5. Pediatric Oncology Department, Curie Institut, Paris, France

    Hélène Pacquement MD & Gudren Schleiermacher MD

  6. Pediatric Oncology Department, Armand Trousseau Hospital, Paris, France

    Marie-Dominique Tabone MD

  7. Radiology Department, Gustave Roussy Cancer Campus Grand Paris, Villejuif, France

    Sandra Canale MD

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  1. Steven Yevich MD
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  2. Natalie Gaspar MD
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  12. Frederic Deschamps MD
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Correspondence to Steven Yevich MD.

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Yevich, S., Gaspar, N., Tselikas, L. et al. Percutaneous Computed Tomography-Guided Thermal Ablation of Pulmonary Osteosarcoma Metastases in Children. Ann Surg Oncol 23, 1380–1386 (2016). https://doi.org/10.1245/s10434-015-4988-z

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  • DOI: https://doi.org/10.1245/s10434-015-4988-z

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