Purpose To evaluate the technical feasibility and safety of percutaneous cryoablation (CA) for the treatment of single/oligometastatic lymph-node (LN) relapse in different anatomic regions. MATERIALS AND METHODS This is a retrospective study of all patients who underwent percutaneous CA of LN metastases (May 2014-April 2019). RESULTS Eighteen patients with a total of 27 LNs were treated with CT-guided CA (Galil Medical, Israel). One patient was excluded since no follow-up was available. The mean LN diameter was 11 mm (range 4-28 mm). Thirteen patients had a history of previous treatment for locoregional lymphadenopathy. In 21 LNs, a supplementary thermal insulation-displacement technique was used (hydrodissection = 12; carbodissection = 6; both = 3). According to the RECIST criteria, 8 LNs had a complete response, 8 stable disease, 8 partial response and 1 progressive disease. In the subgroup of patients with prostate cancer relapse, the mean PSA level before treatment was 5.5 ngr/ml (range 0.6-36 ngr/ml) and reduced to 0.32 (range 0-1.1 ngr/ml) and 0.3 (range 0-0.6 ngr/ml) at 3- and 6-month follow-up, respectively. Six patients presented distant tumor deposits on follow-up that were further treated with systemic (5 patients: hormone/chemo/immunotherapy) and local therapies (1 patient: CA of bone oligometastatic disease). No major complication was noted. Two patients with obturator LN presented transient obturator nerve paresis. Mean follow-up was 15 months (range 1-56 months). CONCLUSION In this series of patients, we have shown that metastatic LNs can be safely treated with image-guided CA. Caution should be paid, and additional measures should be taken when treating LNs near thermal-sensible structures.

中文翻译：

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挽救淋巴结经皮低温消融：安全性和肿瘤学结果。

目的评估经皮冷冻消融（CA）在不同解剖区域治疗单发/少转移淋巴结（LN）复发的技术可行性和安全性。材料与方法这是对所有经皮CA注射LN转移的患者（2014年5月至2019年4月）进行的回顾性研究。结果18例总共27个LN的患者接受了CT引导的CA（以色列Galil Medical）的治疗。由于没有随访资料，因此排除了一名患者。LN的平均直径为11毫米（范围为4-28毫米）。13位患者曾有局部区域淋巴结病的既往治疗史。在21个LN中，使用了辅助的绝热位移技术（水力剥离= 12；碳纤维剥离= 6；两者= 3）。根据RECIST的标准，有8个LN完全反应，有8个稳定疾病，8例局部反应和1例进行性疾病。在患有前列腺癌复发的患者亚组中，治疗前的平均PSA水平为5.5 ngr / ml（范围为0.6-36 ngr / ml），并降至0.32（范围为0-1.1 ngr / ml）和0.3（范围为0-0.6） ngr / ml）分别在3个月和6个月的随访中。六例患者在随访中表现出远处的肿瘤沉积，并进一步接受全身性治疗（5例：激素/化学疗法/免疫疗法）和局部疗法（1例：骨少转移性疾病的CA）。没有发现严重并发症。两名闭孔LN患者出现短暂性闭孔神经麻痹。平均随访时间为15个月（1-56个月）。结论在这一系列患者中，我们已经证明，影像引导的CA可以安全地治疗转移性LN。要当心