Cryoablation in the Treatment of Onco-urology Patients with Oligometastatic Bone Lesions
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Keywords

cryosurgery
navigation
cryoablation
metastasis-directed therapy
oligometastases

How to Cite

Prokhorov, G. G., Burovik, I. A., Nosov, A. K., Prokhorov, D. G., Shchekuteev, N. A., & Berkut, M. V. (2025). Cryoablation in the Treatment of Onco-urology Patients with Oligometastatic Bone Lesions. Voprosy Onkologii, 70(6), 1142–1149. https://doi.org/10.37469/0507-3758-2024-70-6-1142-1149

Abstract

Introduction. The frequency of oligometastatic bone lesions in urology depending on cancer type and stage. In prostate and renal cancers, oligometastic bone lesions are detected in 20-30% of patients at disease manifestation, while they are significantly less common in urothelial cancer. Palliative metastasis-directed therapies, such as percutaneous cryoablation of oligometastases, aim to control pain and improve patients’ quality of life.

Aim. This study aimed to evaluate the effect of minimally invasive percutaneous cryoablation, performed under CT guidance, on pain levels in uro-oncology patients with oligometastatic bone lesions.

Materials and Methods. From 2019 to 2023, percutaneous cryoablation of bone oligometastases was performed on 27 patients with progressive prostate, renal, and bladder cancers at the N.N. Petrov National Medical Research Center of Oncology. The indications for surgery included the potential for complete cytoreduction of clinically significant solitary bone metastases and/or refractory pain due to nerve involvement or compression, leading to sensory and motor disturbances. The minimally invasive percutaneous stereotactic cryoablation procedure was conducted under general anesthesia and CT guidance using the Russian-made "MCS" minimally invasive cryosurgical system with liquid nitrogen. CT imaging and direct thermometry were used to monitor the freezing zone.

Results. Follow-up examinations of 20 patients (74%) one year after metastasis-directed therapy demonstrated complete devitalization of the targeted metastatic lesions. Five patients underwent repeat procedures sequentially as new metachronous metastases appeared. Throughout the observation period, patients' quality of life remained satisfactory. In seven patients, initial pain levels of 4-8 on the visual analog scale (VAS) were completely alleviated following palliative cryoablation, while the remaining patients experienced significant pain reduction.

Conclusions. Minimally invasive stereotactic cryoablation effectively devitalizes bone lesions and may be considered a palliative treatment option for uro-oncology patients to relieve localized pain associated with oligometastases.

https://doi.org/10.37469/0507-3758-2024-70-6-1142-1149
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##article.numberofviews## 118
pdf (Русский)

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