Percutaneous cryoablation in pediatric solid tumors: A case series.

Abstract

e22516 Background: Percutaneous cryoablation is an effective treatment of focal tumors. With a low complication rate it is a useful adjuvant therapy option to chemotherapy and radiation. To date there is no literature on the use of cryoablation in pediatric solid tumors. Methods: We conducted a retrospective analysis of pediatric solid tumor patients who received percutaneous cryoablation for local control of relapsed disease over the past 10 years within our institution. The following information was extracted from EMR: age, diagnosis, number of ablated lesions and tissue involved (lung, liver, bone), complications following procedure, and rate of local relapse. Results: A total of 40 metastatic lesions were treated by percutaneous cryoablation in 7 patients (ages 5-22yo, median 15yo) with a wide range of solid tumor diagnoses (Ewing sarcoma, Wilms tumor, Osteosarcoma, Germ cell tumor). Lesions represented sites of relapse or metastasis, refractory to several lines of therapy. Sites of cryoablated tumor included lung (33%), bone (32%), chest wall (10%) among others. Each patient had 2-5 separate cryoablation procedures (total 22 procedures) over the course of their therapy. 54% of instances patients were monitored overnight for pain control, with no major complications. One patient required ICU-level care due to pulmonary hemorrhage following lung cryoablation in setting of thrombocytopenia. No infectious complications. Three patients progressed and died within two years following first cryoablation intervention (diagnoses of Ewings and Wilms). Of the remaining four patients, control at the ablation site was achieved with median follow-up of 17 months (range 8-43). Conclusions: Percutaneous cryoablation is a safe and durable approach for local control of solid tumors in children. We present the first pediatric case series detailing response to percutaneous cryoablation.