Use of percutaneous microwave ablation for the treatment of bone tumors: a retrospective study of clinical outcomes in 47 patients

Abstract

ObjectiveThe present study aimed to evaluate the short-term clinical performance and safety of percutaneous microwave ablation (MWA) techniques for the treatment of bone tumors.MethodsThis single-institution retrospective study investigated 47 cases of bone tumors treated by MWA from June 2015 to June 2018. The study included 26 patients (55.3%) with benign bone tumors and 21 patients (44.7%) with malignant bone tumors. The tumors were located in the spine or sacrum (15, 31.9%), the upper extremities (6, 12.8%), the lower extremities (17, 36.2%) and the pelvis (9, 19.1%). Outcomes regarding clinical efficacy, including pain relief, quality of life, and intervention-related complications, were evaluated before and after MWA using the visual analog scale (VAS) and the 36-item Short-Form Health Survey (SF-36) scoring system.ResultsOf the 47 patients included in this study, all of them completed follow-up examinations, with a mean follow-up duration of 4.8 ± 1.6 months (range, 2–9 months). Significantly improved VAS and SF-36 scores were recorded after the initial treatment (P<0.001), suggesting that almost 100% of patients experienced pain relief and an improved quality of life following surgery. No major intervention-related complications (e.g., serious neurovascular injury or infection) occurred during or after the treatment. We recorded only three minor posttreatment complications (6.4%, 3/47), which were related to thermal injury that caused myofasciitis and affected wound healing.ConclusionIn our study, the short-term efficacy of MWA was considerably favorable, with a relatively low rate of complications. Our results also showed that MWA was effective for pain relief and improved patients’ quality of life, making it a feasible treatment alternative for bone tumors.

Technological Improvement Rates and Evolution of Energy-Based Therapeutics

“…The main path analysis of the microwave/RF therapeutic domain ( Figure 8 ) has a single cluster and is used for ablation of tissue for the treatment of cancer (liver, kidney, prostate, lung, and bone metastasis) ( 84 , 85 ), cardiovascular diseases (e.g., arrhythmias) ( 57 , 86 ), gynecological [e.g., endometrial ablation to destroy the uterine lining ( 87 ), urological ( 88 ), and orthopedic disorders. Among these treatments, tumor ablation has the largest share ( 84 ).…”

Minimally Invasive Interventional Procedures for Metastatic Bone Disease: A Comprehensive Review

“…Although to date there are still few studies available, literature reports promising results regarding the palliative role of MWA for bone metastases and its efficacy in LTC, proving that MWA is a feasible and effective treatment for pain relief and quality of life improvement [ 107 , 108 , 109 , 110 , 111 , 112 , 113 ]. In a systematic literature review, Sagoo et al [ 108 ] evaluated the use of MWA in the treatment of painful spinal metastases in eight studies, demonstrating MWA to be effective in achieving pain palliation for up to 6 months and local tumor control (success rate of 80-100%).…”

“…Similarly to other percutaneous ablation techniques, MWA can increase the risk of bone pathological fracture, so it has been suggested to combine treatment with cementoplasty [ 111 , 112 , 116 , 117 ]. The MWA complication rate has been estimated at 4.0% (95% CI 1.9–7.3), where transient neural damage, skinburn, myofasciitis and local infection are the most common events [ 109 , 110 ]. In this regard, Kastler et al evaluated the use of thermocouple probes for real-time temperature monitoring during bone MWA with the aim of preventing neural damage, which may occur when temperature reaches 45 °C [ 118 , 119 ].…”

The minimally invasive endoscopic technique for the treatment of symptomatic benign bone lesions: Preliminary results from a retrospective study

“…However, for patients with a refractory limp, pain or potential pathologic fracture, surgical resection and curettage may be considered the mainstay treatment to prevent lesion progression [6] . Nonetheless, conventional open surgery generally involves high risks of complications, is extremely invasive to the soft tissue and the bone/cartilage, and may greatly compromise the overall efficacy of surgery in the long term [7] , [8] . In recent years, minimally invasive surgical techniques have been widely used to treat both benign and malignant bone lesions, which are thought to be associated with a less invasive operation, resulting in decreased intraoperative blood loss, a shorter hospital stay, early pain palliation and reduced complication rates [9] .…”

“…More importantly, the number of treated bone lesions and the availability of various techniques are increasing because of the development of more advanced minimally invasive surgical instruments and approaches [5] , [10] . Accumulating evidence shows that various methods, including radiofrequency ablation (RFA), microwave ablation (MWA), endoscopic techniques, percutaneous pedicle screw fixation (PPSF), percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP), are being widely and successfully applied in the treatment of symptomatic bone lesions [8] , [11] , [12] , [13] , [14] , [15] , [16] .…”