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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2016

01-04-2016 | Thoracic Oncology

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

Authors: Steven Yevich, MD, Natalie Gaspar, MD, Lambros Tselikas, MD, Laurence Brugières, MD, Hélène Pacquement, MD, Gudren Schleiermacher, MD, Marie-Dominique Tabone, MD, Ernesto Pearson, MD, Sandra Canale, MD, Jane Muret, MD, Thierry de Baere, MD, Frederic Deschamps, MD

Published in: Annals of Surgical Oncology | Issue 4/2016

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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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Metadata
Title
Percutaneous Computed Tomography-Guided Thermal Ablation of Pulmonary Osteosarcoma Metastases in Children
Authors
Steven Yevich, MD
Natalie Gaspar, MD
Lambros Tselikas, MD
Laurence Brugières, MD
Hélène Pacquement, MD
Gudren Schleiermacher, MD
Marie-Dominique Tabone, MD
Ernesto Pearson, MD
Sandra Canale, MD
Jane Muret, MD
Thierry de Baere, MD
Frederic Deschamps, MD
Publication date
01-04-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 4/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4988-z

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