Safety and Efficacy of Percutaneous Cryoablation of Extraspinal Thyroid Cancer Bone Metastases with Curative Intent: Single-Center Experience with a Median Follow-up of More than 5 Years.

ABSTRACT

PURPOSE: To determine the oncologic outcomes and safety profile of image-guided percutaneous cryoablation (PCA) for extraspinal thyroid cancer bone metastases with curative intent. MATERIALS AND METHODS: Between January 2010 and January 2020, 16 consecutive patients (8 men, 8 women; mean age, 61 years ± 19; range, 30-84 years) with 18 bone metastases (median bone tumor size, 19 mm; interquartile range [IQR], 12-29 mm; range, 7-58 mm) underwent PCA of oligometastatic extraspinal bone metastases. Thirteen (81%) patients were radioiodine therapy resistant. Two patients underwent 2 bone tumor ablations in a single session. Procedural data, oncologic outcomes, follow-up (with magnetic resonance imaging and positron emission tomography-computed tomography), and adverse events were retrospectively investigated. Local tumor progression-free survival, disease-free survival, and overall survival were estimated using the Kaplan-Meier method. RESULTS: A median of 2 cryoprobes (IQR, 1.25-3 cryoprobes; range, 1-7 cryoprobes) were used, with 2 freezing cycles; the median length of freezing was 20 minutes (IQR, 17-20 minutes; range, 10-20 minutes). The technical success was 100% (18/18), and the primary technical efficacy was 94.4% (17/18). The median follow-up was 68 months (IQR, 38-93 months). During follow-up, 3 of 17 (17.6%) tumors demonstrated local progression at 7, 13, and 27 months. Consequently, the 1-, 2-, 3-, 4-, and 5-year local tumor progression-free survivals were 93.3%, 84.6%, 76.9%, 75%, and 72.7%, respectively. Two of 16 (12.5%) patients died during follow-up at 43 and 88 months. The major adverse event rate was 5.5% (1/18) with 1 postablative acromion fracture. CONCLUSIONS: PCA for extraspinal thyroid cancer bone metastases demonstrated high local tumor control rates with a safe profile at long-term follow-up.