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Salvage Lymph-Node Percutaneous Cryoablation: Safety Profile and Oncologic Outcomes

  • Clinical Investigation
  • Interventional Oncology
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

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.

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland

    Georgia Tsoumakidou, Katerina Mandralis, Arnaud Hocquelet, Rafael Duran & Alban Denys

Authors
  1. Georgia Tsoumakidou
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  2. Katerina Mandralis
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  3. Arnaud Hocquelet
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  4. Rafael Duran
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  5. Alban Denys
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Correspondence to Georgia Tsoumakidou.

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Tsoumakidou, G., Mandralis, K., Hocquelet, A. et al. Salvage Lymph-Node Percutaneous Cryoablation: Safety Profile and Oncologic Outcomes. Cardiovasc Intervent Radiol 43, 264–272 (2020). https://doi.org/10.1007/s00270-019-02341-3

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  • DOI: https://doi.org/10.1007/s00270-019-02341-3

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